慢性阻塞性肺疾病患者血清基质金属蛋白酶、VEGF水平的变化及其临床意义

Changes and clinical significance of serum matrix metalloprotase and VEGF level of patients with COPD

目的探讨慢阻肺患者血清基质金属蛋白酶(MMP-9)、VEGF水平的变化及其临床意义。方法选取2014年8月-2016年5月在我院接受治疗的慢阻肺患者为观察对象,根据其疾病分期分为急性加重期组(50例)和稳定期组(45例),同时选取50例在我院参与体检的健康成年人的基本资料作为正常对照组。观察三组血清基质金属蛋白酶、VEGF、炎症细胞因子水平、肺功能和气道阻力的差异,分析慢阻肺患者血清基质金属蛋白酶、VEGF水平与炎症细胞因子、肺功能和气道阻力的相关性。结果急性加重期组和稳定期组患者血清MMP-9、VEGF、IL-6、hs-CRP、TNF-α水平和气道阻力指标Z5、Fres、R5等均高于对照组患者,且急性加重期组患者血清基质金属蛋白酶、VEGF水平与炎症细胞因子和气道阻力指标均高于稳定期组患者,差异有统计学意义(P<0.05)。急性加重期组和稳定期组患者肺功能指标FVC、FEV_1及FEV_1/FVC水平均低于对照组患者,且急性加重期组患者肺功能指标均低于稳定期组患者,差异有统计学意义(P<0.05)。慢阻肺患者的MMP-9和VEGF水平与患者炎症细胞因子水平和气道阻力正相关,与肺功能指标负相关。结论慢阻肺患者的基质金属蛋白酶、VEGF水平有升高,且与患者的肺功能降低、炎症细胞因子水平和气道阻力上升密切相关。

Objective To discuss the changes and clinical significance of serum matrix metal-protease( mmmp-9) and VEGF level in patients with COPD. Methods From August 2014 to May 2016,95 COPD patients were divided into the acute group( n = 50) and the stable group( n = 45) according to the disease stage,and 50 healthy people were taken as the control group. Their matrix metalloproteinases,serum VEGF and inflammatory cytokine levels were observed,and the differences between lung function and airway resistance were analyzed. The correlation of pulmonary function and airway resistance was analyzed. Results The serum levels of MMP-9,VEGF,IL-6,hs CRP,and the levels of TNF alpha and airway resistance index Z5,forward and R5 were higher in the COPD group than in the control group,and the levels of matrix metalloproteinases,serum VEGF and inflammatory cytokines and airway resistance index were higher than in the acute group than in the stable group( P < 0. 05). The value of FVC,FEV1,and FEV1/FVC were lower in the COPD group than in the control group,and they were also lower in the stable group than in the acute group( P < 0. 05). The mmp-9 and VEGF levels in patients with COPD were positively correlated with the level of inflammatory cytokines and airway resistance,and were negatively correlated with lung function indicators. Conclusion The stromal metalloproteinase and VEGF levels in patients with COPD are elevated,and they are associated with lower lung function,inflammatory cytokines and increased airway resistance.