创伤后急性呼吸窘迫综合征患者基质金属蛋白酶9的变化及己酮可可碱治疗对其的影响

Change of serum matrix metalloproteinase-9 in patients with acute respiratory distress syndrome after trauma and the effect of pentoxifylline on it

目的:探讨急性呼吸窘迫综合征(ARDS)患者血基质金属蛋白酶9(MMP-9)水平的变化及己酮可可碱(PTX)治疗对其的影响。方法:对61例收入ICU内的ARDS患者分为PTX治疗组和对照组,对两组患者血清MMP-9水平、呼吸频率、氧合指数(PaO2/FiO2)、PaCO2、APACHEⅡ评分进行测定。结果:(1)两组患者治疗前各项值呼吸频率、PaCO2(mmHg)、PaO2/FiO2、年龄及MMP-9水平差异无显著性;(2)PTX治疗可显著减少ARDS患者血清中MMP-9的表达(P<0.05),显著改善ARDS患者的呼吸情况,改善APACHEⅡ评分(P<0.001)。结论:PTX抑制ARDS的MMP-9表达和改善呼吸情况,对ARDS患者有保护作用。

Objective To detect the change of serum matrix metalloproteinase-9 （MMP-9） in patients with acute respiratory distress syndrome （ARDS） after trauma and the effect of pentoxifylline （PTX） on it. Methods 61 patients with ARDS after trauma were divided into PTX treatment group and control group. Serum level of MMP-9,respiratory rate, oxygenation index（PaOJFiO2）, arterial carbon dioxide tension （PaCO2）, and severity of illness score （acute physiological and chronic health evaluation Ⅱ, APACHE Ⅱ ） in both groups were measured. Results There were no significant differences in respiratory rate, PaO2/FiO2, PaCO2, APACHE Ⅱ , age, and serum level of MMP-9 between the two groups before treatment （P 〉 0.05）. Serum level of MMP-9 was decreased （P 〈 0.05）, respiratory function was improved, and APACHE Ⅱ score was ameliorate （P 〈 0.001） in PTX treatment group. Conclusion PTX can inhibit the expression of MMP-9 and improve patients＇ respiratory function, and shows a protective effect on patients with ARDS after trauma.