类风湿关节炎和系统性红斑狼疮患者血清基质金属蛋白酶2、9检测的意义

目的探讨基质金属蛋白酶（MMPs）在类风湿关节炎（RA）和系统性红斑狼疮（SLE）中的重要作用。方法采用酶联免疫吸附试验和酶谱分析了48例RA和27例SLE患者及186例健康对照者血清中MMP-2和MMP-9的浓度和活性。结果酶谱分析结果显示RA和SLE患者血清MMP-2和MMP-9的活性显著高于对照组（P〈0.01）。ELISA检测结果也表明RA、SLE组的MMP-2和MMP-9浓度明显高于对照组（P〈0.05）。结论MMP-2和MMP-9在RA和SLE患者血清中的水平及活性明显升高,表明MMPs在这些自身免疫疾病起一定的作用,可作为临床辅助诊断指标。     

急性冠脉综合征患者血清P选择素及基质金属蛋白酶-9水平监测的意义

目的探讨急性冠脉综合征（ACS）患者血清P选择素及基质金属蛋白酶-9（MMP-9）水平及其临床意义。方法选取40例临床确诊的ACS患者,15例稳定心绞痛（SA）和15名健康对照者,采用酶联免疫吸附试验（ELISA）测定P选择素及MMP-9水平。结果ACS患者外周血清P选择素、MMP-9水平均高于SA组及对照组（P〈0．01）;ACS患者治疗后P选择素、MMP-9水平均低于治疗前（P〈0．01）。结论血清P选择素、MMP-9浓度升高与ACS的发生存在密切的关系,血清P选择素、MMP-9浓度升高可以作为ACS发生的预测指标。     

高血压脑出血患者血清NSE、MMP-9水平变化及其临床价值

目的通过观察急性高血压脑出血患者血清神经元特异性烯醇化酶（NSE）、基质金属蛋白酶-9（MMP-9）水平变化,探讨其临床检测价值。方法选取临床确诊的128例急性高血压脑出血患者及同期体检健康者50例,采用酶联免疫吸附（EusA）法定量检测血清NSE、MMP-9水平,应用SPSS13．0软件包进行统计学处理。结果急性高血压脑出血患者血清NSE、MMP-9水平显著高于健康对照组（P〈0．01）,大量出血者血清NSE、MMP-9水平显著高于小量出血者（P〈0．01）,意识不清者血清NSE、MMP-9水平显著高于意识清醒者（P〈0．01）。本文死亡率为32．81％（42／128）,血清NSE异常组的死亡率（35．7％）显著高于正常组（12．5％）（P〈0．01）,血清MMP-9异常组的死亡率（36．1％）显著高于正常组（15．0％）（P〈0．01）。结论怠性高血压脑出血患者血清NSE、MMP-9水平显著升高,血清NSE、MMP-9定量测定可作为判断急性高血压脑出血患者病情轻重及评价发生意外的客观指标。     

混合性结缔组织病患者抗-U1RNP及血清MMP-3和MMP-9含量变化的相关性研究

目的探讨混合性结缔组织病（MCTD）患者血清MMP-3及MMP-9的水平及意义及抗一UIRNP相关性,为临床治疗、判断预后提供新的理论依据。方法采用双抗体夹心法ELISA测定89例MCTD患者（就诊前6个月内未用过免疫抑制剂及糖皮质激素）和65例正常健康对照者血清MMP-3及MMP-9的水平,并选取部分患者进行治疗后的MMP-3测定,比较不同时期MMP-3的水平。同时采用免疫斑点法测定U1RNP抗体并测定其治疗前的其它实验室指标：ESR、CRP、血清球蛋白。结果MCTD患者血清MMP-3及MMP-9水平分别是（235．62±158．51）ng／ml和（168．25±10．91）明显高于正常对照组（62．72±25．41）（32．04±4．68）ng／ml。P〈0．001;40例患者治疗后1年血清MMP-3及MMP-9明显降低,差异有统计学意义（P=0．0015）。MMP-3及MMP-9水平与MCTD患者的ESR、CRP血清球蛋白、U1RNP抗体呈正相关（P〈0．05）;而与发病年龄、痛程无明显关系（P〉0．05）。结论MMP-3、MMP-9在MCTD患者血清中高水平存在并与U1RNP抗体的滴度有明显相关性;能更好的反映MCTD疾病活动程度,可作为除ESR、CRP以外提示MCTD痰病进展与改善的血清学指标;长期正规治疗能显著降低血清MMP-3、MMP-9的水平。     

脑梗死颈动脉粥样硬化患者血清MMP-9水平的测定及临床意义

目的探讨脑梗死患者颈动脉粥样硬化与血清基质金属蛋白酶-9（MMP-9）水平的关系。方法应用彩色Doppler超声诊断仪检测颈动脉内膜中层厚度（IMT）,以及有无斑块形成及斑块形态。应用双抗体夹心酶联免疫吸附法（ELISA）检测100例脑梗死患者的血清MMP-9水平,并进行相关分析。结果不稳定斑块组空腹血清MMPO浓度为（549．93±153．12）ng／ml,高于稳定斑块组和无斑块组的（281．45±120．34）ng／ml和（87．36±23．62）ng／ml,差异具有统计学意义（P〈0．01）。结论血清MMP-9水平的升高,可成为颈动脉粥样硬化斑块易损性的独立预测因素。血清MMP-9水平增高与颈动脉粥样硬化斑块不稳定性密切相关。     

血清高敏C反应蛋白与基质金属蛋白酶检测在冠心病中的应用

目的探讨冠心病患者的血清高敏C反应蛋白（hs—CRP）、基质金属蛋白酶9（MMP-9）指标变化及其与冠心病病变程度的关系。方法选择冠心病患者119例,其中稳定性心绞痛（SA组）51例,不稳定性心绞痛（UA组）34例,心肌梗死（AMI组）34例,另选健康体检者40例（对照组）,应用免疫散射比浊法测定血清hs—CRP指标水平,并采用酶联免疫吸附法（ELISA）测定MMP-9指标水平。比较各组hs—CRP及MMP-9水平的变化。结果冠心病患者血清hs—CRP和MMP-9水平均明显高于对照组（P〈0．01）;且从SA组、UA组到AMI组,此二项指标又逐级升高,组间比较亦具显著性差异（P〈0．05或P〈0．01）;冠心病患者血清hs-CRP及MMP-9水平与冠心病病变程度呈正相关（r=0．932,P〈0．01;r=0．910,P〈0．01）。结论血清hs—CRP及MMP-9水平的变化对分析冠心病的病理发生发展过程及分型具有重要的临床意义。     

急性冠脉综合征患者血清金属蛋白酶-9联合C-反应蛋白检测的临床意义及相关性

目的：探讨血清金属蛋白酶-9（MMP-9）联合C-反应蛋白（CRP）检测在急性冠脉综合征（ACS）中的临床价值。方法：对40例ACS患者和40例健康体检者进行血清MMP-9和CRP的检测并进行比较。结果：ACS患者血清MMP-9和CRP的水平均明显高于对照组（P〈0．01）,ACS患者中血清MMP-9和CRP水平急性心肌梗死（AMI）组高于不稳定性心绞痛（UA）组（P〈0．05）。结论：ACS患者血清MMP-9和CRP水平明显升高,两者测定可以作为评估ACS病情严重程度的敏感指标,是ACS发病的重要危险因素,其检测对ACS的预防、诊断及治疗有重要的临床意义。     

脑梗死患者血清中MMP-9表达水平的临床意义

目的通过动态分析脑梗死患者血清中基质金属蛋白酶-9（MMP-9）的表达水平,探讨患者血清MMP-9表达水平与脑梗死体积、神经功能缺损程度及预后的关系。方法应用酶联免疫吸附法（ELISA）检测120例脑梗死患者（梗死组）和100例健康者（对照组）的血清MMP-9的表达水平。采用统计学方法分析MMP-9水平与脑梗死的关系。结果梗死组血清MMP-9水平在第1、7、14天均明显高于对照组（P〈0．05）,且血清MMP-9水平与脑梗死体积、神经功能缺损程度及患者的预后明显相关。可认为血清MMP-9高水平是判断脑梗死患者预后的独立危险因素。结论血清MMP-9水平升高是脑梗死的一个危险因素。     

基质金属蛋白酶-9及胰岛素抵抗与2型糖尿病颈动脉粥样硬化的相关性研究

目的研究2型糖尿病患者基质金属蛋白酶-9（MMP-9）及胰岛素抵抗与颈动脉粥样硬化的关系。方法采用ELISA法分别检测正常人25例（对照组）、按体重指数（BMI）分成糖尿病非肥胖组26例和糖尿病肥胖组34例患者的血清MMP-9水平和胰岛素抵抗指数（HOMA-IR）等生化指标，应用彩色多普勒超声测量颈动脉内膜中层厚度（IMT）进行相关分析。结果糖尿病2组的HbAlc、FPG、FINS、HOMAIR、MMP-9、IMT的指标较对照组明显增高（P〈0．05或0．01），糖尿病肥胖组的FINS、HOMAIR、MMP-9的水平均高于非肥胖组（P〈0．05或0．01），而HbAlc、FPG、IMT相比较没有显著性差异（P〉0．05）。相关分析表明糖尿病2组血清MMP-9和HOMA-IR指标与IMT呈正相关。结论2型糖尿病患者颈动脉粥样硬化病变严重程度与血清MMP-9和HOMA-IR增高有密切的关系。     

过敏性紫癜患儿血清基质金属蛋白酶-9的检测及意义

目的探讨基质金属蛋白酶-9（MMP-9）在过敏性紫癜（HSP）中的作用。方法采用双抗体夹心酶联免疫吸附（ELISA）方法测定40例HSP患儿不同时期的血清MMP-9水平。结果HSP急性发作组血清MMP-9及C-反应蛋白（CRP）水平升高，与正常对照组和缓解组比较，差异均有统计学意义（t分别=12-30、8．42、6．37、8．13，P均〈0．05）；HSP缓解组血清MMP-9仍高，与正常对照组比较，差异有统计学意：L（t=9．92，P〈0．051：HSP急性期并发肾损害组及有胃肠道症状组患儿血清MMP-9水平升高。与无肾损害组及无胃肠道症状组比较，差异有统计学意义（t分别：3．75、3．17，P均〈0．05），而血清CRP水平差异无统计学意义（t分别=0．96、0．56，P均〉0．05）。HSP急性期患儿血MMP-9水平与CRP浓度之间成直线正相关（r=0．68，P〈0．05）。结论MMP-9参与了HSP疾病的病理生理过程。血清MMP-9测定对HSP．尤其是紫癜性肾炎及胃肠道并发症的临床诊断、病情评估及指导治疗有一定帮助。     

Expression of reversion-inducing cysteine-rich protein with Kazal motifs in peripheral blood mononuclear cells from patients with systemic lupus erythematosus: links to disease activity, damage accrual and matrix metalloproteinase 9 secretion

We studied the expression of reversion-inducing cysteine-rich protein with Kazal motifs (RECK) on peripheral blood mononuclear cells (PBMCs), the serum concentration of matrix metalloproteinase 9 (MMP-9) and the MMP-9 secretion ability of PBMCs in patients with systemic lupus erythematosus (SLE), and clinical features were assessed. Compared with PBMCs from healthy donors, PBMCs from SLE patients expressed less RECK protein and mRNA but secreted more MMP-9. The serum concentration of MMP-9 was, however, lower in SLE patients than in healthy donors. The level of RECK protein was inversely associated with the Systemic Lupus International Collaborating Clinics (SLICC) Damage Index (SDI) and MMP-9 secretion in SLE, but no relationship was found between serum MMP-9 concentration and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). In conclusion, the level of RECK protein expressed in PBMCs could be used to predict organ or system damage in SLE and this might help in developing new therapies for SLE targeted at MMP-9.     

56例女性系统性红斑狼疮患者血清肿瘤标志物检测分析

目的探讨女性系统性红斑狼疮（SLE）患者血清肿瘤标志物甲胎蛋白（AFP）、癌胚抗原（cEA）、肿瘤抗原CA125和CA19—9含量变化及临床意义。方法用微粒子酶免疫分析方法测定56例女性SLE患者血清中AFP、CEA、CA125和CA19—9水平,并与健康对照组进行比较。结果女性SLE患者血清AFP、CA125和CA19—9含量显著高于健康对照组,差异有统计学意义（P〈0．05）;CEA水平与健康对照组比较差异无统计学意义;SLE患者CA125阳性率显著升高。结论SLE患者某些血清肿瘤标志物含量较健康对照组增高,可能与器官受累有关。     

系统性红斑狼疮血清性激素水平的研究

目的 系统性红斑狼疮(SLE)血清性激素水平一直没有成为定论,这可能与既往的研究没有考虑卵巢周期对性激素水平的影响,本研究旨在排除这种影响,明确性激素在SLE血清的水平情况,探讨性激素在SLE发病及病程中的作用.方法 测定23例SLE患者血清雌二醇(E2)、孕酮(P)、睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)、泌乳素(PRL)的水平,并采用LACC评分法对病例进行活动性评分.对照组采用年龄、性别和卵巢周期与病例组1:1配对的原则,同时测定上述6种性激素.结果 23例SLE患者血清PRL水平无论在静止期(14例),活动期(9例),还是SLE全体均明显高于正常对照组(P＜0.05或0.01),而LH在3组比较中均明显低于正常对照组(P＜0.05或0.01):T在SLE全体和活动组均明显低于正常对照组(P＜0.05或0.01),SLE患者E2的水平在静止期比正常对照明显增高(P＜0.01).结论 SLE患者血清中PRL升高,LH与T降低可能与SLE病情活动有关.     

急性冠脉综合征伴高同型半胱氨酸血症患者血清VEGF与MMP-9水平检测及临床意义

目的通过检测急性冠脉综合征(ACS)伴高同型半胱氨酸血症患者血管内皮生长因子(VEGF)、基质金属蛋白酶(MMP-9)的血清水平值,探讨VEGF、MMP-9在ACS伴高同型半胱氨酸血症中的发病机制和作用。方法实验分为高同型半胱氨酸血症ACS组与非高同型半胱氨酸血症ACS组。采用酶联免疫吸附试验(ELISA)法检测ACS患者血清VEGF、MMP-9水平。结果 MMP-9在高同型半胱氨酸血症ACS组明显高于非高同型半胱氨酸血症ACS组(P0.05),VEGF在高同型半胱氨酸血症ACS组明显低于非高同型半胱氨酸血症ACS组(P0.05)。VEGF与同型半胱氨酸、MMP-9呈负相关,差异有统计学意义(P0.05),MMP-9与同型半胱氨酸呈正相关性。结论高同型半胱氨酸血症可以通过降低ACS患者血管修复功能及MMPs动态平衡加速冠状动脉粥样硬化,参与ACS的病理生理机制。     

Elevated circulatory MMP-2 and MMP-9 levels and activities in patients with rheumatoid arthritis and systemic lupus erythematosus

ObjectivesMatrix metalloproteinases (MMPs) are suggested to play important roles in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). This study is to examine the MMPs expressions and activities in Taiwanese RA and SLE patients.Design and methodsLevels and activities of plasma MMP-2 and MMP-9 were investigated by enzyme-linked immunosorbent assay and zymography, respectively.ResultsMMP-2 levels in control subjects, RA and SLE patients were 146.1 ± 34.2, 194.0 ± 24.2 and 208.9 ± 75.9 ng/mL respectively, and for MMP-9 were 51.4 ± 57.1, 567.7 ± 313.1 and 208.7 ± 105.5 ng/mL respectively. Both MMP-2 and MMP-9 levels and activities from all patients were significantly higher than that from control subjects.ConclusionsMMP-2 levels in both patients groups were approximately 1.3–1.4 folds higher than that in control subjects, notably, MMP-9 levels were 11- and 4-folds significantly higher, respectively, in RA and SLE patients. The results which MMP-2 and MMP-9 levels and activities are significantly elevated support the involvement of MMPs proteins in these autoimmune disorders.     

Role of serum matrix metalloproteinase-2 and -9 to predict breast cancer progression

ObjectiveMatrix metalloproteinases (MMPs), particularly MMP-2 and MMP-9, have been reported as putative tumor markers because of their involvement in cancer invasion and metastasis. The aim of our study was to elucidate the possible role of MMP-2 and -9 as serum prognostic biomarker for breast cancer classification and correlate it with the clinicopathological variables.Design and MethodsOur study consisted of 60 females with primary breast cancer, 40 cases of benign breast disease and 60 healthy female volunteers as controls. The serum MMP-2 and -9 levels were quantitatively measured by ELISA technique.ResultsA significantly raised MMP-2 and MMP-9 levels were observed in breast cancer patients. Significant rise in serum MMP-9 concentration was found in patients presenting with metastasis as well as in those cases who presented with a duration of less than 1 year. ROC analyses depicted a serum cutoff value of 315 ng/mL for MMP-9 to discriminate the breast cancer patients from the control group.ConclusionOur results suggest that serum MMP-9 level is a better marker than serum MMP-2 in predicting the breast cancer development and progression.     

Serum matrix metalloproteinase-9 concentration in angiographically assessed coronary artery disease

Expression of several matrix metalloproteinases (MMPs) in atherosclerotic plaques has been well documented, and there are findings to indicate that arterial inflammation is reflected in increased serum concentration of matrix metalloproteinase-9 (MMP-9). In coronary atherosclerosis, there is enhanced expression of this MMP, which may be predictive of the severity of the disease. We determined the concentrations of serum MMP-9 in 61 patients (47 males, 14 females) who had >50% obstruction in one or more coronary arteries as assessed by coronary angiography before bypass surgery. In a control group of 19 patients (9 males, 10 females) there were no pathological findings in coronary angiography. ANOVA showed that serum MMP-9 concentrations were highest in patients with 3-vessel coronary artery disease (CAD) (57.3+/-39.1 microg/L, p=0.011). The difference remained statistically significant after adjustment for age, diabetes and sex (p=0.025, ANCOVA). When the groups were compared with each other, serum MMP-9 concentration was higher in the patients with 3-vessel CAD than in those with 1- or 2-vessel CAD (40.4+/-25.1 microg/L, p=0.044) or in the controls (32.2+/- 16.1 microg/L, p=0.007). These results show that serum MMP-9 is elevated in patients with severe coronary stenosis compared with controls. Since MMP-9 has been suggested to reflect inflammation in atherosclerotic plaques, it may be useful in the evaluation of the severity of cardiovascular disease.     

Serum nitrates in patients with systemic lupus erythematosus and antiphospholipid syndrome

AIM: To elucidate clinical implications of nitrates (NO3) concentration as an indicator of nitric oxide (NO) level in blood serum of patients with systemic lupus erythematosus (SLE) and primary antiphospholipid syndrome (PAPS). MATERIAL AND METHODS: Blood serum concentration of NO3 was measured by high-performance liquid chromatography in a total of 41 patients with SLE (n = 17), PAPS (n = 14) and secondary APS (n = 9). Sera from 10 healthy subjects (donors) served as control. NO3 concentration > 40 mcmol/l was stated high. SLE activity was assessed by V. A. Nasonova's scale and SLEDAI index (SLEDAI > 9 indicated SLE exacerbation). Patients with PAPS were divided into two groups depending on clinical symptoms: 7 patients with significant thrombosis or history of more than two thrombotic complications (group 1); 7 patients with the history of two or less thromboses (group 2). RESULTS: The mean serum nitrate concentration in the SLE group was 43.59 mcmol/l (range 17.06-113.22). The nitrate level of the sAPS + SLE group was 49.81 +/- 27.54 and did not significantly differ from APS (33.67 +/- 14.70). By univariate standard analyses, serum nitrate concentration was significantly higher in patients with high disease activity (57.31 +/- 25.12 vs. 25.62 +/- 6.96, Mann-Whitney test, p < 0.01). The Spearman correlation coefficient of nitrate level with SLEDAI was 0.8 (p < 0.001). CONCLUSION: A nitrate level is increased in patients with active SLE and in APS patients with severe thrombotic complication.