中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
Chinese Journal of Clinicians (Electronic Edition)
2015年
19期
3527-3531
,共5页
蔡仁萍%吕红霞%时海洋%王亚楠%潘倩倩
蔡仁萍%呂紅霞%時海洋%王亞楠%潘倩倩
채인평%려홍하%시해양%왕아남%반천천
支气管扩张症%基质金属蛋白酶 9%金属蛋白酶 1 组织抑制剂%呼吸功能试验%高分辨CT
支氣管擴張癥%基質金屬蛋白酶 9%金屬蛋白酶 1 組織抑製劑%呼吸功能試驗%高分辨CT
지기관확장증%기질금속단백매 9%금속단백매 1 조직억제제%호흡공능시험%고분변CT
Bronchiectasis%Matrix metalloproteinase 9%Tissue inhibitor of metalloproteinase-1%Respiratory function tests%High resolution computed tomography
目的：探讨不同类型支气管扩张症痰中基质金属蛋白酶-9（MMP-9）、基质金属蛋白酶抑制剂-1（TIMP-1）的表达。方法2014年1～6月就诊于泰山医学院附属莱钢医院的稳定期支气管扩张症患者60例，所有患者均经胸部高分辨CT（HRCT）诊断为支气管扩张症，并进行评分及分型，根据分型结果将支气管扩张症患者分为囊状支扩组、柱状支扩组、不规则支扩组及混合支扩组，每组各15例，另设对照组10例。采用ELISA方法检测支气管扩张症患者及对照者痰中的MMP-9、TIMP-1浓度，并计算其比值，同期所有入选者进行肺通气功能及弥散功能检查。结果（1）支扩组痰中的MMP-9含量、MMP-9/TIMP-1比值均高于对照组（P均＜0.05），囊状支扩组MMP-9含量、MMP-9/TIMP-1比值均高于其他支扩组（P均＜0.05）；（2）支扩组肺功能指标FVC%、FEV1%、FEV1/FVC%、DLco%均低于对照组（P均＜0.05）；柱状支扩组及不规则支扩组肺功能以上指标均高于囊状支扩组（P均＜0.05）；（3）痰中MMP-9含量与肺功能FVC%、FEV1%、FEV1/FVC%、DLco%均呈负相关（r=－0.788、－0.885、－0.851、－0.653，P均＜0.05）；TIMP-1与肺功能FVC%、FEV1%、FEV1/FVC%、DLco%均呈正相关（r=0.488、0.649、0.686、0.433，P均＜0.05）；MMP-9/TIMP-1比值与肺功能FVC%、FEV1%、FEV1/FVC%、DLco%均呈负相关（r=－0.675、－0.645、－0.838、－0.603，P均＜0.05）。结论（1）稳定期支气管扩张症患者痰中MMP-9表达升高，TIMP-1无相应升高，MMP-9/TIMP-1比例失衡。（2）痰中MMP-9、TIMP-1及其比值与稳定期支气管扩张症患者的病情严重程度相关，可作为其病情监测的生物标记物，指导临床治疗。（3）支气管扩张症患者肺功能的下降与支气管扩张的分型有一定关系，囊状支气管扩张痰中MMP-9的表达及MMP-9/TIMP-1比值升高更明显，对肺功能的影响相对更严重。
目的：探討不同類型支氣管擴張癥痰中基質金屬蛋白酶-9（MMP-9）、基質金屬蛋白酶抑製劑-1（TIMP-1）的錶達。方法2014年1～6月就診于泰山醫學院附屬萊鋼醫院的穩定期支氣管擴張癥患者60例，所有患者均經胸部高分辨CT（HRCT）診斷為支氣管擴張癥，併進行評分及分型，根據分型結果將支氣管擴張癥患者分為囊狀支擴組、柱狀支擴組、不規則支擴組及混閤支擴組，每組各15例，另設對照組10例。採用ELISA方法檢測支氣管擴張癥患者及對照者痰中的MMP-9、TIMP-1濃度，併計算其比值，同期所有入選者進行肺通氣功能及瀰散功能檢查。結果（1）支擴組痰中的MMP-9含量、MMP-9/TIMP-1比值均高于對照組（P均＜0.05），囊狀支擴組MMP-9含量、MMP-9/TIMP-1比值均高于其他支擴組（P均＜0.05）；（2）支擴組肺功能指標FVC%、FEV1%、FEV1/FVC%、DLco%均低于對照組（P均＜0.05）；柱狀支擴組及不規則支擴組肺功能以上指標均高于囊狀支擴組（P均＜0.05）；（3）痰中MMP-9含量與肺功能FVC%、FEV1%、FEV1/FVC%、DLco%均呈負相關（r=－0.788、－0.885、－0.851、－0.653，P均＜0.05）；TIMP-1與肺功能FVC%、FEV1%、FEV1/FVC%、DLco%均呈正相關（r=0.488、0.649、0.686、0.433，P均＜0.05）；MMP-9/TIMP-1比值與肺功能FVC%、FEV1%、FEV1/FVC%、DLco%均呈負相關（r=－0.675、－0.645、－0.838、－0.603，P均＜0.05）。結論（1）穩定期支氣管擴張癥患者痰中MMP-9錶達升高，TIMP-1無相應升高，MMP-9/TIMP-1比例失衡。（2）痰中MMP-9、TIMP-1及其比值與穩定期支氣管擴張癥患者的病情嚴重程度相關，可作為其病情鑑測的生物標記物，指導臨床治療。（3）支氣管擴張癥患者肺功能的下降與支氣管擴張的分型有一定關繫，囊狀支氣管擴張痰中MMP-9的錶達及MMP-9/TIMP-1比值升高更明顯，對肺功能的影響相對更嚴重。
목적：탐토불동류형지기관확장증담중기질금속단백매-9（MMP-9）、기질금속단백매억제제-1（TIMP-1）적표체。방법2014년1～6월취진우태산의학원부속래강의원적은정기지기관확장증환자60례，소유환자균경흉부고분변CT（HRCT）진단위지기관확장증，병진행평분급분형，근거분형결과장지기관확장증환자분위낭상지확조、주상지확조、불규칙지확조급혼합지확조，매조각15례，령설대조조10례。채용ELISA방법검측지기관확장증환자급대조자담중적MMP-9、TIMP-1농도，병계산기비치，동기소유입선자진행폐통기공능급미산공능검사。결과（1）지확조담중적MMP-9함량、MMP-9/TIMP-1비치균고우대조조（P균＜0.05），낭상지확조MMP-9함량、MMP-9/TIMP-1비치균고우기타지확조（P균＜0.05）；（2）지확조폐공능지표FVC%、FEV1%、FEV1/FVC%、DLco%균저우대조조（P균＜0.05）；주상지확조급불규칙지확조폐공능이상지표균고우낭상지확조（P균＜0.05）；（3）담중MMP-9함량여폐공능FVC%、FEV1%、FEV1/FVC%、DLco%균정부상관（r=－0.788、－0.885、－0.851、－0.653，P균＜0.05）；TIMP-1여폐공능FVC%、FEV1%、FEV1/FVC%、DLco%균정정상관（r=0.488、0.649、0.686、0.433，P균＜0.05）；MMP-9/TIMP-1비치여폐공능FVC%、FEV1%、FEV1/FVC%、DLco%균정부상관（r=－0.675、－0.645、－0.838、－0.603，P균＜0.05）。결론（1）은정기지기관확장증환자담중MMP-9표체승고，TIMP-1무상응승고，MMP-9/TIMP-1비례실형。（2）담중MMP-9、TIMP-1급기비치여은정기지기관확장증환자적병정엄중정도상관，가작위기병정감측적생물표기물，지도림상치료。（3）지기관확장증환자폐공능적하강여지기관확장적분형유일정관계，낭상지기관확장담중MMP-9적표체급MMP-9/TIMP-1비치승고경명현，대폐공능적영향상대경엄중。
Objective To investigate the expression of MMP-9, TIMP-1 in sputum in different types of bronchiectasis.MethodsSixty patients with bronchiectasis in stable stage diagnosed by high-resolution computed tomography (HRCT) were chosen in Laigang Hospital of Taishan University from January to June 2014. The patients were divided into four groups according to four types of HRCT, cylindric, varicose, cystic and mixed type, each group included 15 cases. Control group included 10 cases. ResultsThe levels of MMP-9, TIMP-1 and the ratio of MMP-9/TIMP-1 in bronchiectatic groups were higher than those in the controlled group respectively (P<0.05); and those in the cystic bronchiectatic group were higher than those of other bronchiectatic groups respectively (P<0.05). The FVC%, FEV1%, FEV1/FVC% and DLco% in bronchiectatic groups were lower than that of control group (P<0.05); The above indices of lung function in cylindrical bronchiectatic group and irregular group were higher than those in cystic bronchiectatic group (P<0.05). The MMP-9 level of sputum was negatively correlated with FVC%, FEV1%, FEV1/FVC% and DLco%, respectively (r=-0.788,-0.885,-0.851,-0.653,P<0.05); The level of TIMP-1 was positively correlated with FVC%, FEV1%, FEV1/FVC% and DLco%, respectively (r=0.488, 0.649, 0.686, 0.433,P<0.05). The ratio of MMP-9/TIMP-1 was negatively correlated with FVC%, FEV1%, FEV1/FVC% and DLco%, respectively (r=-0.675,-0.645,-0.838,-0.603,P<0.05). ConclusionThe expression of MMP-9 in stable stage patients with bronchiectasis was higher, but the expression of TIMP-1 was not so high, and the ratio of MMP-9/TIMP-1 was imbalance. The expression of MMP-9, TIMP-1 and the ratio of MMP-9/TIMP-1 in sputum were related with the severity of bronchiectasis in stable stage, and can be used as a biomarker for monitoring the condition of bronchiectasis, guiding clinical therapy. There is a certain relationship between the decreased of pulmonary function and the type of bronchiectasis, the expression of MMP-9, TIMP-1 and the ratio of MMP-9/TIMP-1 of cystic bronchiectasis in sputum was higher than others, and the effects on lung function in cystic bronchiectasis was relatively more serious.
