基质金属蛋白酶-9和基质金属蛋白酶组织抑制剂-1在高原地区慢性肺心病发病机制中的作用

目的探讨基质金属蛋白酶。9（MMP-9）及其基质金属蛋白酶组织抑制剂-1（TIMP-1）在高原慢性肺心病（HACCP）发病机制中的作用。方法选择高原肺心病急性加重期患者56例（A组）、缓解期患者51例（B组）和健康对照组40例（c组），采用双抗体夹心酶联免疫吸附法（ELISA）测定诱导痰上清液中MMP-9、TIMP-1表达，并分析其与呼吸功能的关系。结果A组诱导痰中MMP-9、TIMP-1和MMP-9／TIMP-1比值[分别为（976．33±201．65）．g／ml、（624．35±151．22）ng／ml、（1．55±0．16）]显著高于B组[分别为（426．74±123．14）ng／ml、（326．404-112．21）ng／ml、（1．31±0．14），t值为8．367～17．202，P〈0．01]和C组[分别为（142．55±66．11）ng／ml、（121．78±62．26）ng／ml、（1．14±0．11），t值为13．642—25．832，P〈0．01]；B组显著高于c组（t值为6．827～14．233，P〈0．01）。A、B组诱导痰上清液中MMP-9、TIMP-1、MMP-9／TIMP-1比值与诱导痰中性粒细胞、PaCO：均呈显著正相关（r=0．304～0．743，P〈0．01或P〈0．05），与FEVl％、Pa02均呈显著负相关（r=-0．314～-0．689，P〈0．01或P〈0．05）。结论MMP-9、TIMP-1和MMP-9／TIMP-1比值失衡在HACCP发病机制中起了一定作用，并与中性粒细胞、PaCO：呈显著正相关，与FEV。％、PaO2呈显著负相关。

The role of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 in chronic cor pulmonale at high altitude

Objective To evaluate the role of matrix metalloproteinase-9 （MMP-9） and tissue inhibitor of matrix metalloproteinase-1 （ TIMP-1 ） in the pathogenesis of chronic cor pulmonale at high altitude （HACCP）. Methods The date of induced sputum supematants of 56 patients in the acute exacerbated HACCP（ group A） , 51 patients in the stable HACCP（ group B） and 40 healthy controls（ group C） was ana- lyzed. Sputum supematant expressions of MMP-9 and TIMP-1 were measured by enzyme-linked immunosorbent assay（ELISA）. The relationship between MMP-9 or TIMP-1 and respiratory function was analyzed. Results The expressions of MMP-9, TIMP-1 and MMP-9/TIMP-1 ratio [ （976. 33 ±201.65 ） ng/ml, （624.35 ±151.22） ng/ml, （1.55±0. 16） , respectively] in induced sputum supematants were significantly higher in group A than those in group B [ （426.74 ± 123.14） ng/ml, （ 326.40± 112.21 ） ng/ml, （ 1.31± 0.14）, respectively, t = 8. 367 - 17. 202, P 〈 0.01 ] and in group C [ （ 142.55 ± 66.11 ） ng/ml, （ 121.78 ± 62.26） ng/ml, （ 1.14 ± 0.11 ）, respectively, t = 13. 642 - 25. 832, P 〈 0. 01 ] ; those in group B were significantly higher than those in group C （t = 6. 827 ± 14.233, P 〈 0.01 ）. MMP-9, TIMP-1 and MMP-9/ TIMP-1 ratios in group A and B were positively correlated with neutrophils and PaCO2 （r = 0.310 -0.743, P 〈 0.01 or P 〈 0.05）, negatively correlated with FEV1% and PaO2 （ r = - 0. 304 - 0.689, P 〈 0. 01 or P 〈 0.05）. Conclusion MMP-9, TIMP-1 and the imbalanced ratio of MMP-9/TIMP-1 may not only play a role in the pathogenesis of HACCP, but also positively relate to neutrophils and PaCO2 , and negatively relate to FEV1% and PaO2.