肺结核患者血清中MMP-9、VEGF的水平及其意义的探讨

The Investigation of the Serum MMP-9 and VEGF and Its Role in Active Pulmonary Tuberculosis Patients

目的通过检测肺结核患者血清中的MMP-9、VEGF水平．讨论二者与肺结核临床特点的关系。方法采用ELISA方法检测活动性肺结核患者、肺癌患者及健康人血清MMP-9、VEGF水平。结果①肺结核患者血清MMP-9、VEGF水平显著高于健康人（P〈0．001），但显著低于肺癌患者水平（P〈0．001）；②痰菌阳性结核组血清中MMP-9、VEGF水平较痰菌阴性结核组明显增高（P〈0．05）；肺内病变广泛组血清MMP-9、VEGF水平较肺内病变局限组明显增高（P〈0．05）：肺内病变有空洞组血清MMP-9水平较肺内病变无空洞组明显增高（P〈0．05）。而血清VEGF水平在两组间无明显差别：③血清MMP-9、VEGF水平诊断活动性肺结核的敏感性和特异性均较高。结论活动性肿结核患者血清MMP-9、VEGF水平与肺结核临床特点密切相关．是具有较高价值的标志物．

Objective To study the relationship between serum levels of MMP-9,VEGF and the clinical characteristics in active pulmonary tuberculosis patients. Methods Serum levels of MMP-9 and VEGF were detected by ELISA method in 72 patients with active pulmonary tuberculosis and 50 patients with lung cancer, and with a control of 52 eases of healthy group. Results ① The serum levels of MMP-9 and VEGF in active pnlmouary tuberculosis patients （238.65±13.31ng/ml, 412.54±11.52pg/ml） were sigvificantly higher than those in control group（90.07±13.55ng/ml , 368.68±5.82pg/ml,P〈0.001 ）,but they were significantly lower than those in lung cancer patients（659.34±33.56ng/ml, 712.43±112.34pg/ml,P〈0.001 ②The serum levels of MMP-9 and VEGF in active pulmonary tuberculosis patients were significantly higher in patients with advanced disease and sputum positive than in those with only limited disease changes and sputum negative （P〈0.05）.But only the serum level of MMP-9 in active pulmonary tuberculosis patients were significantly higher in patients with pulmonary cavity （P〈0.05）. ③Serum MMP-9 levels confered a sensitivity of 91.70% and a specificity of 60.59% for the diagnosis of active pulmonary tuberculosis, whereas VEGF levels had 86.50% sensitivity and 76.90% specificity. Conclusion The detennination of the serum levels of MMP-9 and VEGF may constitute a supplementary test for the diagnosis of pulmonary tuberculosis.