COPD患者血清MMP-9、TIMP-1的表达与治疗反应性的相关性研究

Study on the Correlation of Serum MMP-9 and TIMP-1 with Treatment Response of Patients with Chronic Obstructive Pulmonary Disease

[目的]探讨慢性阻塞性肺疾病（c0PD）血清基质金属蛋白酶9（MMP-9）、基质金属蛋白酶组织型抑制剂1（TIMP_1）与治疗反应性的相关性。[方法]检测65例未规范化治疗COPD患者（COPD组）及健康志愿者26例（对照组）血清MMP-9、TIMP-1的表达，分析其与肺功能、功能性呼吸困难评分（MRC）、圣乔治呼吸问卷评分（SGRQ）的相关性。[结果]COPD组血清MMP-9、TIMP-1表达显著高于对照组（P〈0．05），但MMP-9／TIMP-1与对照组比较差异无统计学意义（P〉0．05）；COPD组血清MMP-9、TIMP-1、MMP-9／TIMP-1与第1秒用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1／FVC无相关性（P〉0．05），TIMP-1与MRC、SGRQ总分、活动评分、影响评分呈正相关（P〈0．05）；低MMP-9、MMP-9／TIMP-1表达组，治疗后FVC改善较高表达组明显（P〈0．05），低TIMP-1表达组，治疗后FEV1、MRC改善较高表达组明显（P〈0．05），MMP-9、TIMP-1、MMP-9／TIMP-1与SGRQ改善情况无关；Logistic回归分析显示肺功能改善（FEV1改善率≥5％和／或FVC改善率≥10％）与血清MMP-9浓度、基础FEV1及FVC相关。[结论]COPD患者血清MMP-9、TIMP-1增高，与患者症状及生活质量评分相关；且其表达与COPD短期治疗反应性具有一定相关性。

[Objective]To explore the correlation of serum matrix metalloproteinase-9（MMP-9） and tissue inhibitor of metalloproteinase-1 （TIMP-1） with lung function indicators of chronic obstructive pulmonary disease （COPD）. [Methods] Serum levels of MMP-9 and TIMP-1 in 65 COPE） patients without standardized treatment（COPD group） and 26 healthy volunteers（control group） were measured. The relationship of MMP-9 and TMP-1 with lung function, functional dyspnea score（MRC） and St. George＇s respiratory questionnaire score（SGRQ） were analyzed. [Results]Serum levels of MMP-9 and TIMP-1 in COPE） group patients were significantly higher than those in control group（ P 〈0.05）, but there was no significant difference in MMP-9/TIMP-1 between COPD group and control group（ P 〈0.05）. In COPD group, serum levels of MMP-9, TIMP-1 and MMP-9/TIMP-1 had no relation with FEV1, FVC and FEV1/FVC（ P〉0.05）, while TIMP-1 was positively correlated with MRC, total score of SGRQ, activity score and impact score（ P 〈0. 05）. The improvement of FVC in low MMP-9 and MMP-9/TIMP-1 group after treatment was more obvious than that in high expression group（ P〈0.05）. The improvement of FEV1 and MRC in low TIMP-1 group after treatment was more obvious than that in high expression group（ P 〈0.05）. MMP-9, TIMP-1 and MMP-9/TIMP-1 had no association with the improvement of SGRQ. Logistic regression analysis showed that the improvement of lung function（the improvement of FEV1 ≥ 5% and/or the improvement of FVC1 10%） was correlated with serum MMP-9, basal FEV1 and FVC. [Conclusion] Serum MMP-9 and TIMP-1 in COPD patients increase and are correlated with the scores of symptoms and quality of life of patients. The expressions of MMP-9 and TIMP-1 have certain relation with short-term treatment response of COPD.