社区获得性肺炎患者血清MMP-9水平的变化与意义

Study on the serum level and change of MMP-9in patients with comunityacquired pneumonia

目的探讨基质金属蛋白酶-9(MMP-9)在社区获得性肺炎(CAP)患者血清中的水平变化及其诊断价值。方法100例成人CAP患者为病例组,96例成人健康体检者为对照组,采用ELISA法检测病例组发病期、治疗后与对照组血清MMP-9的水平,以受试者工作特征(ROC)曲线分析血清MMP-9水平在CAP中的诊断价值;并对病例组血清MMP-9水平与白细胞计数(WBC)、中性粒细胞比例(NEUT)进行相关性分析。结果病例组发病期MMP-9水平明显高于治疗后与对照组(P<0.001),治疗后MMP-9水平与对照组差异无统计学意义(P=0.120)。MMP-9的ROC曲线下面积为0.749,Cutoff值为231.05 ng/ml时,灵敏度和特异度分别为0.641、0.780,阳性预测值和阴性预测值分别为0.743、0.684。病例组血清MMP-9水平与WBC、NEUT均呈正相关(r分别为0.503、0.307,P<0.001、P<0.013)。结论 MMP-9参与了CAP的炎症反应过程,并可作为诊断CAP的一种血清标志物。

Objective To explore the serum level of matrix metalloproteinase- 9（ MMP- 9） and its diagnosis value in community acquired pneumonia（ CAP）. Methods The serum of 100 adult patients with CAP as the case group,and 96 healthy adults were collected as the control group. Enzyme linked immunosorbent assay（ ELISA） was used to test the serum level of MMP- 9,the receiver operator characteristic（ ROC） curve was used to evaluate the diagnosis value of serum MMP- 9 in CAP. The relationship between the serum level of MMP- 9 and white blood cell count（ WBC）,percentage of neutrophils（ NEUT） were evaluated by pearson＇ test. Results The serum level of MMP- 9 of the case group in period of disease was significantly higher than that of the case group after treatment（ P〈0. 001）,as well as the control group（ P〈0. 001）,and the difference between the case group after treatment and the control group has no statistical significance（ P = 0. 120）. The area under（ ROC） curve（ AUC） of MMP-9 was 0. 749. When the Cutoff value was 231. 05 ng/ml,the sensitivity and specificity were 0.641 and0. 780,the positive predictive value and negative predictive value were 0. 743 and 0. 684 respectively. The serum level of MMP- 9 were positively correlated with WBC and NEUT in the case group（ r = 0. 503,0. 307 and P〈0. 001,0. 013 respectively）.Conclusion MMP- 9 involves in the inflammatory response process of CAP,and can be used as a serum marker for diagnosing CAP.