中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2010年
6期
441-444
,共4页
周乐飞%姜莉%李振华%康健
週樂飛%薑莉%李振華%康健
주악비%강리%리진화%강건
肺纤维化%结节病,肺%基质金属蛋白酶类
肺纖維化%結節病,肺%基質金屬蛋白酶類
폐섬유화%결절병,폐%기질금속단백매류
Pulmonary fibrosis%Sarcoidosis,pulmonary%Matrix metalloproteinases
目的 探讨特发性肺纤维化(IPF)和结节病患者基质金属蛋白酶(MMP)-1和MMP-7的变化及其临床意义. 方法 经临床确诊的IPF患者44例为IPF组,其中男23例、女21例,年龄46～70岁,平均(58±9)岁;Ⅱ期结节病患者20例为结节病组,其中男9例、女11例,年龄35～65岁,平均(50±12)岁.均进行肺功能和支气管肺泡灌洗检查.采用酶联免疫吸附试验测定血清和BALF中MMP-1和MMP-7水平.非正态分布的计量资料以中位数表示,采用两个独立样本比较的Wilcoxon秩和检验进行统计学分析,采用Spearson相关性检验进行相关分析. 结果 IPF组患者血清和BALF中MMP-1中位数(范围)分别为3.78(0.14～13.44)和1.09(0.04～5.14)μg/L,均明显低于结节病组的7.79(4.67μ10.68)和2.08(0.05μ4.16) μg/L,两组血清中MMP-1水平的差异有统计学意义(z=-3.53,P<0.01);IPF组患者血清和BALF中MMP-7中位数(范围)分别为7.83(3.57～14.37)和3.75(1.10～9.87)μg/L,均明显高于结节病组的4.04(0.06～9.94)和1.16(0.02～4.47)μg/L,两组血清和BALF中MMP-7水平的差异均有统计学意义(z值分别为-3.84和-5.33,均P<0.01).IPF组患者血清中MMP-7水平与DLCO占预计值%和BALF中性粒细胞构成比呈显著负相关(r值分别为-0.56和-0.47,均P<0.01),IPF组患者BALF中MMP-7水平与DLCO占预计值%呈显著负相关(r=-0.31,P<0.05). 结论 在肺纤维化炎症细胞浸润阶段MMP-1水平高于纤维化阶段,在纤维化基质重塑阶段MMP-7水平高于炎症阶段.MMP-7有可能作为肺纤维化严重程度的参考指标.
目的 探討特髮性肺纖維化(IPF)和結節病患者基質金屬蛋白酶(MMP)-1和MMP-7的變化及其臨床意義. 方法 經臨床確診的IPF患者44例為IPF組,其中男23例、女21例,年齡46～70歲,平均(58±9)歲;Ⅱ期結節病患者20例為結節病組,其中男9例、女11例,年齡35～65歲,平均(50±12)歲.均進行肺功能和支氣管肺泡灌洗檢查.採用酶聯免疫吸附試驗測定血清和BALF中MMP-1和MMP-7水平.非正態分佈的計量資料以中位數錶示,採用兩箇獨立樣本比較的Wilcoxon秩和檢驗進行統計學分析,採用Spearson相關性檢驗進行相關分析. 結果 IPF組患者血清和BALF中MMP-1中位數(範圍)分彆為3.78(0.14～13.44)和1.09(0.04～5.14)μg/L,均明顯低于結節病組的7.79(4.67μ10.68)和2.08(0.05μ4.16) μg/L,兩組血清中MMP-1水平的差異有統計學意義(z=-3.53,P<0.01);IPF組患者血清和BALF中MMP-7中位數(範圍)分彆為7.83(3.57～14.37)和3.75(1.10～9.87)μg/L,均明顯高于結節病組的4.04(0.06～9.94)和1.16(0.02～4.47)μg/L,兩組血清和BALF中MMP-7水平的差異均有統計學意義(z值分彆為-3.84和-5.33,均P<0.01).IPF組患者血清中MMP-7水平與DLCO佔預計值%和BALF中性粒細胞構成比呈顯著負相關(r值分彆為-0.56和-0.47,均P<0.01),IPF組患者BALF中MMP-7水平與DLCO佔預計值%呈顯著負相關(r=-0.31,P<0.05). 結論 在肺纖維化炎癥細胞浸潤階段MMP-1水平高于纖維化階段,在纖維化基質重塑階段MMP-7水平高于炎癥階段.MMP-7有可能作為肺纖維化嚴重程度的參攷指標.
목적 탐토특발성폐섬유화(IPF)화결절병환자기질금속단백매(MMP)-1화MMP-7적변화급기림상의의. 방법 경림상학진적IPF환자44례위IPF조,기중남23례、녀21례,년령46～70세,평균(58±9)세;Ⅱ기결절병환자20례위결절병조,기중남9례、녀11례,년령35～65세,평균(50±12)세.균진행폐공능화지기관폐포관세검사.채용매련면역흡부시험측정혈청화BALF중MMP-1화MMP-7수평.비정태분포적계량자료이중위수표시,채용량개독립양본비교적Wilcoxon질화검험진행통계학분석,채용Spearson상관성검험진행상관분석. 결과 IPF조환자혈청화BALF중MMP-1중위수(범위)분별위3.78(0.14～13.44)화1.09(0.04～5.14)μg/L,균명현저우결절병조적7.79(4.67μ10.68)화2.08(0.05μ4.16) μg/L,량조혈청중MMP-1수평적차이유통계학의의(z=-3.53,P<0.01);IPF조환자혈청화BALF중MMP-7중위수(범위)분별위7.83(3.57～14.37)화3.75(1.10～9.87)μg/L,균명현고우결절병조적4.04(0.06～9.94)화1.16(0.02～4.47)μg/L,량조혈청화BALF중MMP-7수평적차이균유통계학의의(z치분별위-3.84화-5.33,균P<0.01).IPF조환자혈청중MMP-7수평여DLCO점예계치%화BALF중성립세포구성비정현저부상관(r치분별위-0.56화-0.47,균P<0.01),IPF조환자BALF중MMP-7수평여DLCO점예계치%정현저부상관(r=-0.31,P<0.05). 결론 재폐섬유화염증세포침윤계단MMP-1수평고우섬유화계단,재섬유화기질중소계단MMP-7수평고우염증계단.MMP-7유가능작위폐섬유화엄중정도적삼고지표.
Objective To detect the levels of matrix metalloprotease(MMP)-1 and MMP-7 in the serum and the bronchoalveolar lavage fluid(BALF)of patients with idiopathic pulmonary fibrosis(IPF)and sarcoidosis(Stage Ⅱ),and therefore to investigate the significance of these changes in the pathogenesis of IPF. Methods Forty-four clinically confirmed cases of IPF were recruited,with the patients'age ranging from 46 to 70 years(58±9 years).Twenty patients with sarcoidosis,aged 35 to 65(50±12)years,were also studied.Enzyme-linked immunoabsorbent assay was used to detect the levels of MMP-1 and MMP-7 in the serum and the BALF samples. Results In the serum of patients with IPF,the level of MMP-1 [3.78 (0.14-13.44) μLg/L]was lower than that in patients with sarcoidosis[7.79(4.67-10.68)μg/L(z=-3.53,P<0.01)],but the level of MMP-7[7.83(3.57-14.37) μg/L]was higher than that in patients with sarcoidesis[4.04(0.06-9.94)μg/L(z=-3.84,P<0.01)].In the BALF of patients with IPF,the level of MMP-1 [1.09(0.04-5.14)μg/L]was lower than that in patients with sarcoidosis [2.08(0,05-4.16)μg/L(z=-1.53,P>0.05)],but the level of MMP-7[3.75(1.10-9.87)μg/L]was highet than that in patients with sarcoidosis[1.16(0.02-4.47)μg/L(x=-5.33,P<0.01)].The serum level of MMP-7 in patients with IPF was negatively correlated with the diffusing capacity of carbon monoxide(r=-0.56,P<0.01)and the percentage of neutrophils(r=-0.47,P<0.01).The level of MMP-7 in the BALF showed a negative correlation with diffusing capacity of carbon monoxide(r=-0.31,P <0. 05). Conclusions The results suggest that MMP-1 may be increased in the inflammatory phase as compared to the matrix remodeling phase of lung fibrosis, while MMP-7 may be increased in the matrix remodeling phase rather than in the inflammatory phase. MMP-7 may act as an important indicator for the severity of IPF.
