【摘要】 目的分析慢性阻塞性肺疾病(COPD)不同时期患者血清基质金属蛋白酶9(MMP-9)、基质金属蛋白酶组织抑制剂1(TIMP-1)及转化生长因子β(TGF-β)水平及其相互调节作用,并探讨其临床意义。方法选择COPD缓解期组、急性加重期组和正常对照组各20例,用酶联免疫吸附法检测各组血清MMP-9、TIMP-1和TGF-β的表达水平,探讨各组间有无差异,并分析其与肺功能的关系。结果①1秒钟用力呼气容积占预计值的百分比(FEV1%)在COPD缓解期为(59.1±5.6)%和急性加重期为(34.6±4.6)%,均低于正常对照组的(99.1±11.3)%(P<0.01),急性加重期又低于缓解期(P<0.05);FEV1/用力肺活量(FVC)在COPD缓解期为(53.1±10.8)%和急性加重期为(31.2±11.3)%,均低于正常对照组的(84.0±6.7)%(P<0.01),急性加重期又低于缓解期(P<0.05)。②血清MMP-9浓度在COPD缓解期为(203.0±33.5)μg/L和急性加重期为(221.7±30.4)μg/L,均高于正常对照组的(131.4±44.5)μg/L(P<0.01);TIMP-1浓度在COPD急性加重期为(213.2±27.2)μg/L,比缓解期的(149.9±20.1)μg/L增高(P<0.05),而缓解期比正常对照组的(84.1±14.0)μg/L明显增高(P<0.01);MMP-9/TIMP-1比值在急性加重期为(1.1±0.2)和缓解期为(1.3±0.1),均低于正常对照组的(1.5±0.3)(P<0.01);TGF-β浓度在COPD急性加重期为(902.5±49.2)ng/L,明显高于正常对照组的(546.2±36.1)ng/L(P<0.01)。③COPD组血清MMP-9、TIMP-1、TGF-β浓度均与肺功能指标FEV1%、FEV1/FVC呈负相关(P<0.01),而MMP-9/TIMP-1与FEV1%、FEV1/FVC呈正相关(P<0.01);COPD急性加重期血清TGF-β浓度与TIMP-1呈正相关(P<0.01)。结论COPD不同时期血清MMP-9、TIMP-1、TGF-β及MMP-9/TIMP-1含量不同,且与其肺功能水平具有一定相关性。它们在体内存在复杂的相互调节机制,共同在肺气肿气道重塑中发挥重要作用。更多还原

【Abstract】 Objective To study the serum levels of matrix metalloproteinase-9(MMP-9),tissue inhibitors of matrix metalloproteinases-1 (TIMP-1) and transforming growth factor-β(TGF-β) and their inter-regulation in the patients with chronic obstructive pulmonary disease(COPD) during different periods,and investigate the clinical significance.Methods Using enzyme-linked immunosorbent assay(ELISA) to test the serum levels of MMP-9,TIMP-1 and TGF-β in 20 normal persons,20 patients with COPD during an acute exacerbation and 20 patients at a stable period, in order to investigate their difference and analyze the relationship between these indexes and pulmonary function.Results ① Forced expiratory volume in one second(FEV1)% in the patients with COPD at a stable period (59.1±5.6)% and those during an acute exacerbation (34.6±4.6)% were lower than that of normal controls (99.1±11.3)%(P<0.01),and the index in patients with COPD during an acute exacerbation was lower than that at a stable period(P<0.05); FEV1/forced vital capacity(FVC) in the patients with COPD at a stable period (53.1±10.8)% and that during an acute exacerbation (31.2±11.3)% were also lower than that of normal controls (84.0±6.7)%(P<0.01),and the index in the patients with COPD during an acute exacerbation was lower than that at a stable period(P<0.05).② The serum level of MMP-9 in the patients with COPD at a stable period (203.0±33.5) μg/L and that during an acute exacerbation (221.7±30.4) μg/L were higher than that of normal controls (131.4±44.5) μg/L(P<0.01); The serum level of TIMP-1 in patients with COPD during an acute exacerbation (213.2±27.2) μg/L was higher than that at a stable period (149.9±20.1) μg/L(P<0.05),and the latter was significantly higher than that of normal controls (84.1±14.0) μg/L(P<0.01);MMP-9/TIMP-1 in the patients with COPD during an acute exacerbation (1.1±0.2) and that at a stable period (1.3±0.1) were lower than that of normal controls (1.5±0.3)(P<0.01); The serum level of TGF-β in the patients with COPD during an acute exacerbation (902.5±49.2) ng/L was higher than that of normal controls (546.2±36.1) ng/L(P<0.01).③ The serum level of MMP-9,TIMP-1 and TGF-β in the patients with COPD negatively correlated with FEV1% and FEV1/FVC(P<0.01),while MMP-9/TIMP-1 positively correlated with FEV1% and FEV1/FVC(P<0.01);The serum level of TGF-β positively correlated with the serum level of TIMP-1(P<0.01). Conclusion There are different serum levels in different periods of COPD,and there are certain relationships between these indexes and pulmonary function.In the body there are complicated inter-regulatory mechanisms among those indexes,which play an important role in the blood vessel remodeling of pulmonary emphysema.更多还原