基质金属蛋白酶及其抑制物在胸腔积液中的表达

Expression of matrix metalloproteinase and tissue inhibitorof metalloproteinase in pleural effusion

目的检测良、恶性胸腔积液中MMP-2、MMP-9、TIMP-2的含量以及MMP-2/TIMP-2比值为鉴别良、恶性胸腔积液提供依据。方法收集胸腔积液患者153例,其中漏出液(心力衰竭25例、低蛋白血症17例)42例,结核性胸腔积液54例,恶性胸腔积液57例,采用酶联免疫吸附法(ELISA法)分别检测胸水中MMP-2、MMP-9、TIMP-2的含量以及MMP-2/TIMP-2比值。结果结核性胸腔积液组中MMP-2、MMP-9、TIMP-2含量依次为(99.65±26.30)μg/L、(62.92±5.56)μg/L、(88.81±25.65)μg/L,显著高于漏出液组MMP-2、MMP-9、TIMP-2含量(64.55±12.18)μg/L,(62.92士5.56)μg/L,(10.67士3.02)μg/L,(41.43±11.27)μg/L,P<0.01;显著低于恶性胸腔积液组MMP-2、MMP-9、TIMP-2含量(121.23±14.09)μg/L,(31.12±4.05)μg/L、(108.43士16.37)μg/L,P<0.01。结核性胸腔积液组中MMP-2/TIMP-2(1.40±0.24)低于漏出液组(1.62±0.22),高于恶性胸腔积液组(1.14±0.27),P>0.05。结论在恶性胸水中MMP-2、MMP-9、TIMP-2含量明显升高;MMP-2、MMP-9、TIMP-2以及可作为良、恶性胸水的鉴别指标。

Objective To study the expression of MMP-2、MMP-9、TIMP-2 and MMP-2/TIMP-2 proteins in pleural effusion and analyse the difference between benign and malignant pleural effusion.Methods One hundred and fifty-three patients with pleural effusion were collected： 42 patients with transudate（25 patients from heart failure,17 patients from hypoproteinemia）,54 patients with tuberculous pleural effusion,57 patients with malignant pleural effusion.All of levels of MMP-2,MMP-9,TIMP-2 were detected by enzyme-linked immunosorbent assay（ELISA） method.Results Levels of MMP-2,MMP-9 and TIMP-2[（99.65±26.30）μg/L,（31.12±4.05）μg/L,（88.81±25.65）μg/L] in the patients with tuberculous pleural effusion were significantly higher than those in transudate[（64.55±12.18）μg/L,（10.67±3.02）μg/L,（41.43±11.27）μg/L,P0.01];But they were significantly lower than those in malignant pleural effusion[（121.23±14.09）μg/L,62.925.56）μg/L,（108.43±16.37）μg/L,P0.01].Ratios of MMP-2/TIMP-2（1.40±0.24） in the patients with tuberculous pleural effusion were lower than those in transudate（1.62±0.22）.But they were higher than those in malignant pleural effu-sion（1.14±0.27,P0.05）.Conclusion Levels of MMP-2、MMP-9 and TIMP-2 in the patients with malignant pleural effusion are high remarkably.MMP-2,MMP-9,TIMP-2 are the standards to distinguish tuberculous pleural effusion and malignant characters.