劳力性热射病患者APACHEⅡ评分与TIMP-1及MMP-9、PCT的相关性研究

[目的]探讨劳力性热射病（EHS）患者血清中基质金属蛋白酶抑制剂-1（TIMP-1）水平与基质金属蛋白酶-9（MMP-9）、降钙素原（PCT）等相关因子水平及与急性生理与慢性健康状况评分Ⅱ（APACHEⅡ）的相关性.[方法]回顾性分析本院住院部2010年5月至2013年10月收治的49例EHS患者,根据患者的APACHEⅡ评分为低分组、高分组.比较两组患者的TIMP-1、PCT、MMP-9水平（采用ELISA方法检测）及与APACHEⅡ评分的相关性.[结果]在不同APACHEⅡ评分患者中,低分组患者的TIMP-1水平明显高于高分组患者,MMP-9、PCT水平则明显低于高分组患者,且两组相比较差异均有显著性（均P＜0.01）.相关分析显示TIMP-1与A-PACHEⅡ评分存在明显负相关（P＜0.01）,MMP 9、PCT等与APACHEⅡ存在正相关（P＜0.01）.[结论]EHS患者血清炎症因子与APACHEⅡ评分关系密切,可作为病情进展评价及疗效判定的指标,其可为临床诊疗该疾病提供新的思路.

Study on the Relationship of APACHE Score with TIMP-1, MMP-9 and PCT in Patients with Exertional Heat Stroke

[Objective]To explore serum levels of the related factors such as matrix metalloproteinase inhibitor-1 （TIMP-1）,matrix metalloproteinase-9 （MMP-9） and procalcitonin （PCT） in patients with exertional heat stroke（EHS） and their relationship with acute physiology and chronic health evaluation score Ⅱ （APACHE Ⅱ score）.[Methods] A total of 49 patients with EHS in the in-patient department of our hospital from May 2010 to Oct.2013 were analyzed retrospectively.According to APACHE Ⅱ score,all patients were divided into low score group and high score group.The levels of TIMP-1,PCT and MMP-9（detected by ELISA method） in two groups were compared and their relationship with APACHE Ⅱ score was analyzed.[Results] Among the patients with different APACHE Ⅱ scores,TIMP-1 in low score group was obviously higher than that in high score group,but the levels of MMP-9 and PCT in low score group were obviously lower than those in high score group,and there were significant differences between two groups（P ＜0.01）.Correlation analysis showed that there was obvious negative correlation between TIMP-1 and APACHE Ⅱ score level（P ＜0.01）,and positive correlation of MMP-9 and PCT with the grading（P ＜0.01）.[Conclusion]Serum levels of inflammatory cytokines in patients with EHS are closely related to APACHE Ⅱ,and can be used as the index for disease progression evaluation and efficacy assessment,and may provide new ideas for clinical diagnosis and treatment of the disease.