MMP、IGF和PCT水平变化在脑梗死合并肺部感染患者中的意义

Significance of changes in MMP,IGF and PCT levels in patients with cerebral infarction complicated with pulmonary infection

目的探讨基质金属蛋白酶(matrix metalloproteinases,MMP)、胰岛素样生长因子(insulin like growth factor,IGF)和降钙素原(procalcitonin,PCT)在脑梗死合并肺部感染患者诊治中的临床价值。方法选择我院2014年1月至2016年3月间我院收治的脑梗死合并肺部感染患者40例作为脑梗死并肺部感染组,选择40例同期在我院治疗的单纯脑梗死患者设为梗死组,40例体检的健康者设为对照组,对比梗死并肺部感染组、梗死组与对照组,以及轻度、中度及重度肺部感染患者之间的MMP、IGF和PCT水平,并分析MMP、IGF和PCT水平与脑梗死合并肺部感染的关系。结果脑梗死并肺部感染组患者随着肺部感染程度的升高血清MMP各指标水平均明显升高,与梗死组及对照组比较差异均有统计学意义(P <0. 05),不同程度肺部感染患者的血清MMP各指标水平呈现出重度患者>中度患者>轻度患者,且差异有统计学意义(P <0. 05);脑梗死并肺部感染组与梗死组的血清IGF-2及PCT水平均明显高于对照组,而IGF-1和IGF-3水平明显低于对照组,且脑梗死并肺部感染组与梗死组之间、不同程度肺部感染患者之间的差异均有统计学意义(P <0. 05);经logistic回归分析结果显示,患者血清MMP、IGF相关指标及PCT与脑梗死合并肺部感染关系密切(P <0. 05)。结论脑梗死合并肺部感染患者的MMP、IGF和PCT水平呈现出异常变化,其与脑梗死合并肺部感染关系密切,且变化程度可以反映病情程度。

Objective To investigate the clinical significance of matrix metalloproteinase （MMP）, insulin- like growth factor （ICF） and procalcitonin （PCT） in the diagnosis and treatment of cerebral itffarction complicated with pulmonary infeetion. Methods 40 patients with cerebral infaretion and pulmonary ilffeetion were enrolled in our hospital from January 2014 to March 2016. 40 patients with infareted and pulmonary infeetion were selected. 40 patients with cerebral infaretion were treated with cerebral infaretion as the infaretion group, and 40 eases of physical examination were set as the control group. The levels of MMP, ICF and PCT were compared between the ilffaret and pulmonary infeetion group, the ilffaret group and the control group, and the patients with mild, moderate and severe pulmonary infeetion, and the levels of MMP, ICF and PCT were compared with cerebral infaretion. Results The levels of serum MMPs were significantly increased in the patients with infarction and pulmonary infection, and there was significant difference between the infarct group and the control group （P 〈 0. 05 ）. The levels of serum IGF-2 and PCT in the infareted and pulmonary ilffeetion group and the infaret group were significantly higher than those in the control group （ P 〈 0. 05 ） , while the levels of IGF-1 and IGF-3 were significantly lower than those in the control group, and there was significant difference between the ilffaret and the pulmonary infeetion group and the ilffaret group and the patients with different degrees of pulmonary infeetion （ P 〈 0. 05 ）. The logistic regression analysis showed that the correlation between serum MMP and IGF and PCT was closely related with cerebral infarction and pulmonary infection （ P 〈 0. 05）. Conclusion The levels of MMP, IGF and PCT in patients with cerebral infarction complicated with pulmonary infeetion show abnormal changes, which are closely related with cerebral infaretion and pulmonary ilffeetion, and the degree of change could reflect the degree of disease.