血清基质金属蛋白酶-9 在肺结核鉴别诊断中的价值分析

目的:分析血清基质金属蛋白酶-9(MMP 9)在肺结核鉴别诊断中的价值。方法:选取肺结核、肺炎、肺癌患者及健康志愿者各60 例分别作为肺结核组、肺炎组、肺癌组和对照组,对受试者血清MMP-9 水平检测分析。结果:对照组、肺结核组、肺炎组、肺癌组研究对象的血清MMP-9 水平分别为(1 976.36±907.44)ng/ ml、(4 350.45±2 574.75)ng/ ml、(2 135.68±1 263.56)ng/ ml 和(2 590.38±1 532.84)ng/ ml,差异有统计学意义(F =25.000,P<0.001),其中,肺结核组患者的血清MMP-9水平显著高于其他三组(P<0.001),肺癌组患者的血清MMP-9 水平显著高于对照组,差异有统计学意义(P<0.05)。血清MMP-9 在肺结核与健康人+肺炎+肺癌、健康人、肺炎、肺癌、肺炎+肺癌鉴别诊断中的受试者工作特征曲线下面积(AUC)分别为0.739、0.769、0.751、0.699、0.725(P 均<0.05)。结论:肺结核患者表现为血清MMP-9 水平显著升高,且幅度高于肺癌或肺炎患者,血清MMP-9 有助于肺结核鉴别诊断和筛查,但应注意适当提高诊断的灵敏度。

Analysis on value of serum matrix metalloproteinase-9 in differential diagnosis of pulmonary tuberculosis

Objective: To analyze the value of serum matrix metalloproteinase-9 ( MMP-9) in differential diagnosis of pulmonary tuberculosis.Methods: 60 cases of patients with pulmonary tuberculosis,pneumonia or lung cancer patients respectively and 60 cases of healthy volunteers were selected as the tuberculosis group,the pneumonia group,the lung cancer group and the control group.The serum levels of MMP-9 of all the subjects were detected and compared.Results: The serum levels of MMP-9 of the subjects in the control group,the pulmonary tuberculosis group,the pneumonia group and the lung cancer group were (1 976.36±907.44) ng/ ml,(4 350.45±2 574.75) ng/ ml,(2 135.68±1 263.56) ng/ ml and (2 590.38±1 532.84) ng/ ml respectively,the difference wasstatistically significant (F = 25.000,P<0.001),among them,the serum MMP-9 level of the patients in the pulmonary tuberculosis group was significantly higher than that of the other three groups (P<0.001),the serum MMP-9 level of the patients in the lung cancer group were significantly higher than that of the control group,the difference was statistically significant (P<0.05).The areas under the receiver operating characteristic curve (AUC) of the serum MMP-9 in differential diagnosis of pulmonary tuberculosis versus healthy people+pneumonia+lung cancer,healthy people,pneumonia,lung cancer,and pneumonia+lung cancer were 0.739,0.769,0.751,0.699,0.725 respectively (P<0.05).Conclusion: The patients with pulmonary tuberculosis show significantly higher serum MMP-9 level,which is significantly higher than that in the patients with pneumonia or lung cancer,can be used as a serum marker for the diagnosis and screening of pulmonary tuberculosis,but more attention should be paid to improve the sensitivity of the diagnosis properly.