慢性阻塞性肺疾病患者血清MMP-9、TNF-α与骨转换生化指标及骨密度的关系

Relationship between serum levels of MMP-9 and TNF-α with bone turnover biochemical indicators and bone mineral density in patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)并发骨质疏松患者血清基质金属蛋白酶(MMP-9)、肿瘤坏死因子-α(TNF-α)与骨转换标志物、骨密度的相关性。方法选取该院接诊稳定期COPD患者84例,根据患者骨密度(BMD)测试结果将其分为骨质疏松组(28例)、低骨量组(26例)与正常骨量组(30例),采用ELISA法检测各组MMP-9、TNF-α水平,以及骨转化生化标志物血清骨特异性碱性磷酸酶(sBAP)、血清骨钙素(sOC)、血清I型胶原羧基末端肽(sCTX)。结果骨质疏松组、低骨量组血清MMP-9、TNF-α水平高于正常骨量组,骨质疏松组血清MMP-9、TNF-α水平高于低骨量组,差异均有统计学意义(P<0.05)。骨质疏松组sBAP、sOC低于正常骨量组,sCTX高于正常骨量组,低骨量组sBAP、sOC低于正常骨量组,骨质疏松组sBAP低于低骨量组,sCTX高于低骨量组,差异均有统计学意义(P<0.05)。骨质疏松组、低骨量组腰椎骨密度、腰椎骨密度T值、股骨颈股密度与股骨骨密度T值均低于正常骨量组(P<0.05),骨质疏松组腰椎骨密度、腰椎骨密度T值、股骨颈股密度与股骨骨密度T值低于低骨量组(P<0.05)。血清MMP-9与骨转换生化指标、骨密度水平均呈负相关(P<0.05);TNF-α与骨转换生化指标呈负相关(P<0.05)。结论 COPD并发骨质疏松患者MMP-9、TNF-α呈现为高表达,与骨转换生化指标存在负相关性,同时与骨密度也存在一定关系。

Objective To investigate the relationship between serum matrix metalloproteinase(MMP-9)and tumor necrosis factor alpha(TNF-α)with bone turnover markers and bone mineral density(BMD)in the patients with chronic obstructive pulmonary disease(COPD)complicating osteoporosis.Methods Eighty-four cases of stable stage of COPD admitted to our hospital were selected and divided into the osteoporosis group(28cases),low bone mass group(26cases)and normal bone mass group(30cases)according to the BMD detection results.ELISA was adopted to detect the MMP-9,TNF-α,bone turnover biochemical markers sBAP,sOC and sCTX levels.Results Serum MMP-9,TNF-αlevels in the osteoporosis group and low bone mass group were higher than those in the normal bone mass group,which in the osteoporosis group were higher than those in the low bone mass group,the differences were statistically significant(P<0.05);the sBAP and sOC levels in the osteoporosis group was lower than those in the normal bone mass group,while the sCTX level was higher than that of the normal bone mass group;the sBAP and sOC levels in the low bone mass group were lower than those in the normal bone mass group,the sBAP level in the osteoporosis group was lower than that in the low bone mass group,the sCTX level was higher than that of low bone mass group,the differences were statistically significant(P<0.05);the lumbar vertebral BMD and its T value,femoral neck BMD and its T value in the osteoporosis group and low bone mass group were lower than those in the normal bone mass group(P<0.05),which in the osteoporosis group were lower than those in the low bone mass group(P<0.05);serum MMP-9was negatively correlated with bone turnover biochemical markers and BMD level(P<0.05);TNF-αwas negatively correlated with bone turnove biochemical markers(P<0.05).ConclusionMMP-9and TNF-αare highly expressed in the patients with COPD complicating osteoporosis,and negatively correlated with the bone bone turnove biochemical markers,meanwhile have a certain relationship with BMD.