摘要
目的探讨基质金属蛋白酶-9（MMP-9）及其抑制剂1（TIMP-1）在糖皮质激素（简称激素）治疗重度慢性阻塞性肺疾病急性加重期（AECOPD）的变化及意义。方法以双抗体夹心EUSA法检测AECO—PD患者激素治疗组（41例）和对照组（40例）治疗前后血清MMP-9和TIMP-1水平，并分析与肺功能的关系。结果①AECOPD激素治疗组血清MMP-9、TIMP-1浓度、MMP-9／TIMP-1比值[分别为（189．25±52．38）μg／L，（198．38±43．45）μg／L，0．92±0．37]明显低于治疗前[（246．10±68．64）μg／L，（217．63±62．34）μg／L，1．09±0．23]，差异均有统计学意义（P〈0．01，P〈0．05，P〈0．05）；对照组治疗后MMP-9、TIMP-1、MMP-9／TIMP-1下降，但治疗前、后比较差异无统计学意义（P均〉0．05）。②激素治疗组治疗后1秒钟用力呼气容积（FEV1l）、FEV1占正常预计值百分比[（0．83±0．35）L，（46±17）％]比治疗前[（0．72±0．48）L，（34±15）％]有明显改善（P均〈0．05）。结论糖皮质激素治疗后患者MMP-9、TIMP-1、MMP-9／TIMP-1下降，FEV1％占正常预计值有明显改善；协调MMP-9／TIMP-1比例失衡，可能是糖皮质激素治疗重度AECOPD机制之一。
Objective To explore the role of matrix metalloproteinase 9 （MMP-9） and tissue inhibitor of metalloproteinase-1 （TIMP-1） in patients with acute exacerbation of severe chronic obstructive pulmonary diseases （AECOPD） treated with glucocorticoids. Methods The serum /evels of MMP-9 and TIMP-1 were measured by ELISA in 41 patients with AECOPD before and after treatment with glucocorticoids and in 40 patients with regular methods（ control group）. Results ①After treatment with glucocorticoids, the serum levels of MMP-9 （ 189.25 ± 52.38 ） μg/L,TIMP-1 （ 198.38±43.45 ） μg/L, ratio of MMP-9/TIMP-1 （0.92±0.37 ） were decreased significantly than before （ （ 246.10±68.64 ） μg/L, （ 217.63±62.34 ） μg/L, （ 1.09 ± 0.23 ） ） （ P 〈 0.01, P 〈 0.05, P 〈 0.05 ） ; but there were no differences （P 〉 0.05 ） in regular methods （control group） ;②After treatment with glucocorticoids, FEV1, FEV1% （ （0.83 ± 0.35 ） L, （ 46 ± 17 ） % ） were improved than before （ （ 0.72 ±0.48 ） L, （ 34 ± 15 ） % ） （ P 〈 0.05）. Conclusions After treatment with glucocorticoids, the serum levels of MMP-9, TIMP-1, ratio of MMP-9/ TIMP-1 from patients with COPD were decreased significantly, and FEV1 ,FEV1% were improved significant; Glueocortieoids can alleviate severe AECOPD to some degrees, which might be related to improving the imbalance of MMP-9/TIMP-1.
出处
《中国综合临床》
2010年第1期38-40,共3页
Clinical Medicine of China
