百草枯中毒患者血清MMP-9 TNF-α和IL-6水平与预后的相关性研究

Correlation study on serum MMP - 9, TNF - α and IL - 6 levels with the prognosis of paraquat poisoning patients

目的 探讨百草枯中毒（paraquat poisoning, PQP）患者血清基质金属蛋白酶-9（MMP-9）、肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平变化与病情严重程度及预后的关系.方法 回顾性分析58例PQP患者的临床资料,根据临床转归分为存活组（n=18）和死亡组（n=40）,另选15例健康成人作为对照组,采用双抗体夹心酶联免疫吸附法（ELISA）测定患者入院后第1、3、7天血清MMP-9、TNF-α和IL-6水平,并采用急性生理学与慢性健康评分Ⅱ（APACHEⅡ）对患者病情程度进行分析.结果 存活组、死亡组与对照组相比,患者血清MMP-9、TNF-α和IL-6水平明显升高（P〈0.05）,死亡组患者血清MMP-9、TNF-α和IL-6水平明显高于存活组（P〈0.01）;死亡组患者APACHEⅡ评分高于存活组（P＜0.05）;血清MMP-9、TNF-α和IL-6水平与APACHEⅡ评分具有相关性（r=0.262,0.269,0.388;P＜0.05）.结论 MMP-9、TNF-α和IL-6参与了PQP的发病过程,并与PQP病情严重程度及预后有一定相关性;可作为早期反映病情严重程度的参考指标和PQP预后不良的预警指标.

Objective To explore the correlation between serum MMP- 9, TNF -α, IL- 6 levels and the prognosis of paraquat poisoning （PQP） patients. Methods In this retrospective study, 58 PQP patients were enrolled and divided into survival group （n = 18 ） and death group （n =40 ）. 15 cases of healthy adults were served as control group for determination of serum cytokine levels. The serum cytokine （ MMP - 9, TNF - α and IL - 6） levels were detected by ELISA method. The severity of patient＇s condition was assessed with acute physiology and chronic health evaluation Ⅱ （ APACHEⅡ ） system. Results The levels of serum MMP - 9,TNF - α and IL - 6 were significantly higher in survival group and death group than in the control group （ P 〈 0.05 ）, while the levels of serum MMP - 9, TNF - ot and IL-6 was higher in death group than in the survival group（ P 〈0.01 ）. The APACHE Ⅱ score of death group was higher than that of survival group（ P 〈0. 05 ）. Levels of serum MMP - 9 ,TNF - α and IL - 6 were correlated with APACHE Ⅱ score （ r =0. 262,0. 269, 0. 388 ; P 〈 0. 05 ）. Conclusion MMP-9,TNF- α and IL-6 involved in the pathogenesis of PQP, and correlated with the prognosis of PQP patients. Serum MMP - 9, TNF - α, IL - 6 can be used as the reference index of PQP patient＇s condition, and the early - warning index for prognosis of PQP patients.