重症急性胰腺炎合并急性肺损伤患者血MMP-9水平与预后的关系

Relationship between the level of MMP-9 and prognosis in severe acute pancreatitis with lung injury

目的探讨重症急性胰腺炎合并急性肺损伤患者血MMP-9水平对预后的预测价值。方法选择25例重症急性胰腺炎合并急性肺损伤患者作为观察组,分别于入院后1 d、3 d、5 d抽取静脉血检测血浆MMP-9、IL-6和TNF-α水平,患者出院后随访3-9个月,观察疾病复发情况。选取同期30例健康体检者作为对照组。结果①观察组血浆MMP-9、IL-6和TNF-α水平与对照组比较,差异有统计学意义（P〈0.01）;观察组上述指标各观察时点与对照组比较,差异也有统计学意义（P〈0.05或〈0.01）;②血浆MMP-9水平与年龄、血糖、CT评分、感染、PaO2、IL-6、TNFα-等呈正相关（P〈0.01）;③将存活出院的22例患者依据血浆MMP-9值分为MMP-9≤100 ng/ml组和MMP-9〉100 ng/ml组,两组病例的复发率比较差异有统计学意义（P〈0.05）,血浆MMP-9≤100 ng/ml组复发率较低。结论血浆MMP-9含量的检测对重症急性胰腺炎合并急性肺损伤患者预测其不良预后有一定的指导价值。

Objective To evaluate the prognosis of matrix metalloproteinase-9（MMP-9） of plasma in severe acute pancreatitis complicated with lung injury.Methods Twenty-five patients with severe acute pancreatitis complicated with lung injury were observed.On the 1st,3rd and 5th day after hospitalization,the levels of MMP-9,IL-6 and TNF-α of plasma in venous blood were detected with enzyme linked immumosorbent assay（ELISA）.Follow-up contact was made for 3~9 months after discharge.Thirty healthy people were chosen simultaneously as the control group.Results ①The difference of the levels of MMP-9,IL-6 and TNF-α of plasma between the observe group and the control group had statistical significance（P〈0.01） and also in different observe hours（P〈0.05 or 0.01）.②It suggested a positive relation（P〈0.01） between MMP-9 and age,blood sugar,CT Score,infection,PaO2,IL-6 and TNF-α.③Twenty-two discharged patients were divided into two groups：MMP-9≤100 ng/ml and MMP-9100 ng/ml.The recurrence rate of the two groups showed statistical significance（P〈0.05）.The recurrence rate of the group of MMP-9≤100 ng/ml was lower.Conclusion The test of MMP-9 of plasma in severe acute pancreatitis with lung injury has definite reference for poor prognosis.