尿液明胶酶变化在慢性肾脏病中的临床意义

The Clinical Implications of Urinary Matrixmetalloproteinase-2 and Metalloproteinase-9 in Patients with Chronic Kidney Disease

目的:探讨尿MMP-2、MMP-9的水平和活性变化与慢性肾脏病(CKD)患者肾功能及尿蛋白的关系。方法:用ELISA法及明胶酶谱法检测90例CKD患者尿明胶酶(MMP-2、MMP-9)的水平,其中慢性肾小球肾炎(chronicglomerulonephritis,CGN)60例,慢性肾小管间质性肾炎(chronic tubulointerstitial nephritis,CTIN)30例,同时与实验组年龄、性别大致匹配的健康人30例为对照组,分析CKD患者尿明胶酶与血肌酐、尿蛋白的相关性。结果:CGN患者Scr与尿液MMP-2正相关(r=0.508,P<0.01),与尿液MMP-9负相关(r=-0.361,P<0.01)。CGN患者尿蛋白与尿液MMP-2正相关(r=0.429,P<0.01),与尿液MMP-9无相关性(r=-0.090,P=0.492)。CTIN患者Scr与尿液MMP-2正相关(r=0.547,P<0.01),与尿液MMP-9正相关(r=0.570,P<0.01)。CTIN患者尿蛋白与尿液MMP-2、MMP-9均无相关性。CGN组与CTIN组比较,CTIN组尿液MMP-2、MMP-9显著高于CGN组。结论:CKD患者尿液MMP-9、MMP-2均升高,可能参与了CKD的发生及进展过程,CTIN组尿液MMP-9、MMP-2显著高于CGN组,可能在临床辅助诊断上有一定价值。

Objective： To research into the relationship between the levels and active variations of urine MMP-2,MMP-9 and renal function and urinary protein in patients with chronic kidney disease（CKD）.Methods： The levels of urine gelatinase（MMP-2,MMP-9） in 90 patients with CKD are measured by ELISA method and spectral method for the detection of gelatinase,among which 60 cases suffered from chronic glomerulonephritis（CGN）,and 30 cases of chronic tubulointerstitial nephritis（CTIN）.30 cases of healthy people who are roughly matched in age and sex of those in the experimental group were taken as the control group.The correlation of urine gelatinase with serum creatinine and urinary protein is analysed in the paients with CKD.Results： Scr in patirnts with CGN and urinary MMP-2 are positive correlation（r = 0.508,P〈0.01）,but urinary MMP-9 is negative correlation（r =-0.361,P〈0.01）.Urinary protein in patients with CTIN and urine MMP-2 are positive correlation（r = 0.429,P〈0.01） and has no correltion with urinary MMP-9（r =-0.090,P =0.492）.Scr in patirnts with CTIN and urine MMP-2 is positive correlation（r = 0.547,P〈0.01） and that with MMP-9 is also positive correlation（r = 0.570,P〈0.01）.Urinary protein in patients with CTIN and urine MMP-2,MMP-9 has no correlation.Comparing the group of CGN with the group of CTIN,the urine MMP-2,MMP-9 in group CTIN is significantly higher than that in group CKD.Conclusion： Elevated urine MMP-2 and MMP-9 of patients with CKD may be involved in the occurrence and progression of CKD and urine MMP-9 and MMP-2 in group CTIN are significantly higher than thos in the group CGN,which may be of certain value in assistant diagnosis in the clinical practice.