慢性阻塞性肺疾病患者组织基质金属蛋白酶-9、基质金属蛋白酶抑制剂-1及血管内皮生长因子测定的临床价值

Clinical value of matrix metalloproteinases 9,tissue inhibitor of metalloproteinases-1 and vascular endothelial growth factor in patients with chronic obstructive pulmonary disease

目的:探讨慢性阻塞性肺疾病(COPD)急性加重期及稳定期患者,血清组织基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制剂-1(TIMP-1)、血管内皮生长因子(VEGF)的浓度变化及相关性。方法:用酶联免疫吸附法(ELISA)测定73例COPD患者(急性加重期34例,稳定期39例)及对照组32例受试者血清MMP-9、TIMP-1、VEGF的浓度(ng/m L)。结果:(1)COPD患者血清VEGF、MMP-9及TIMP-1的水平以及MMP-9/TIMP-1比值均明显高于正常对照组,急性加重期COPD患者上述指标升高尤为显著。(2)COPD组中,MMP-9与TIMP-1正相关,VEGF与MMP-9、TIMP-1、MMP-9/TIMP-1比值分别具有正相关性。(3)COPD组患者血浆中MMP-9、TIMP-1浓度、MMP-9/TIMP-1浓度比值、VEGF浓度与FEV1/FVC%、FEV1占预计值%均呈负相关性。结论:COPD患者血清MMP-9浓度、TIMP-1浓度、MMP-9/MMP-1比率及VEGF浓度升高,并且与气流阻塞程度成负相关,可以作为评价患者病情严重程度的指标。

Objective： To investigate the serum level of MMP-9,TIMP-1 and VEGF in patients with acute exacerbation and stable stage of chronic obstructive pulmonary disease chronic obstructive pulmonary disease（ COPD） and their correlations between each other. Methods： Enzyme linked immunosorbent assay（ ELISA） was used to determine the serum levels of MMP-9,TIMP-1 and VEGF in 73 patients with COPD（ 34 cases with acute exacerbation,39 cases with stable stage） and 32 subjects in control group（ ng/ml）. Results：1 The serum levels of VEGF,MMP-9 and TIMP-1,and MMP-9/TIMP-1 ratio in patients with COPD were significantly higher than those in the normal control group,especially in patients with acute exacerbation of COPD.2 In the COPD group,MMP-9 was positively correlated with TIMP-1,and VEGF was also correspondingly positively correlated with MMP-9,TIMP-1 and the ratio of MMP-9/TIMP-1. 3 The serum levels of MMP-9,TIMP-1 and VEGF and the ratio of MMP-9/TIMP-1 in COPD group were correspondingly negatively correlated with FEV1/FVC% and FEV1. Conclusion： The serum levels of MMP-9,TIMP-1 and VEGF in patients with COPD and the ratio of MMP-9/MMP-1 are remarkably elevated and negatively related with the level of airflow obstruction,can be used as an indicator of the severity of the disease.