婴幼儿重症肺炎血清中基质金属蛋白酶9与基质金属蛋白酶抑制物1的表达及意义

目的 探讨婴幼儿重症肺炎急性期外周血中基质金属蛋白酶9(MMP-9)及其基质金属蛋白酶抑制因子1(TIMP-1)的表达及临床意义.方法 选取2015年10月至2016年5月于郑州大学第三附属医院儿童重症监护病房住院的婴幼儿重症肺炎20例(重症肺炎组)和同期在本院呼吸病区住院的婴幼儿轻症肺炎25例(轻症肺炎组),依据病原学分为病毒性肺炎组(24例)和非病毒性肺炎组(21例),20例同期健康体检儿童为对照组.采用酶联免疫吸附法测定外周血中MMP-9和TIMP-1水平,并行潮气肺功能检查.结果 所有肺炎患儿血清MMP-9、TIMP-1和MMP-9/TIMP-1水平均显著高于对照组,重症肺炎组高于轻症肺炎组,病毒性肺炎组高于非病毒性肺炎组(均P<0.05);重症肺炎组和轻症肺炎组患儿恢复期肺功能达峰时间比(TPTEF/TE)和达峰容积比(VPTEF/VE)均明显低于对照组,重症肺炎组明显低于轻症肺炎组,病毒性肺炎组低于非病毒性肺炎组(均P<0.05);但患儿潮气量(VT/kg)的组间比较差异无统计学意义.外周血清中MMP-9水平及MMP-9/TIMP-1比值与肺功能TPTEF/TE、VPTEF/VE均呈负相关(r1=-0.459、-0.376;r2=-0.413、-0.327;均P<0.05).结论 急性期血清中MMP-9及 MMP-9/TIMP-1与婴幼儿肺炎严重程度和恢复期肺功能损伤有关,在病毒性肺炎中表现的尤为突出,可作为判断预后的监测指标.

The expression and significance of matrix metalloproteinases-9 and tissue inhibitors of matrix metalloproteinase-1 in serum of infant with severe pneumonia

Objective To explore the expression and significance of matrix metalloproteinases-9(MMP-9) and tissue inhibitors of matrix metalloproteinase-1(TIMP-1) in serum at acute phase of severe pneumonia in infants.Methods A total of 45 infants of pneumonia were selected and divided into 20 cases of severe pneumonia group and 25 cases of mild pneumonia group according to the severity of the disease,and all 45 infants were also divided into virus group of 24 cases and non-virus group of 21 cases on the basis of etiology.Additionally,20 cases of healthy children who accepted the physical examination at the same time were selected as the control group.Serum levels of MMP-9 and TIMP-1 were detected by using ELISA.Tidal breathing lung function was measured in all selected infants.Results Compared with the control group,the serum levels of MMP-9,TIMP-1 and MMP-9/TIMP-1 ratio of the infants with acute pneumonia were significantly higher,the severe pneumonia group were higher than the mild pneumonia group,and the virus group were higher than the non-virus group(P＜0.05).The ratio of the time to reach peak tidal expiratory flow to total expiratory time (TPTEF/TE) and the volume to reach peak tidal expiratory flow to total expiratory volume(VPTEF/VE) of pneumonia group in recovery period were significantly lower than those in the control group,severe pneumonia group were lower than those in the mild pneumonia group,and the virus group were lower than those in the non-virus group (all P＜0.05).There were no statistically significant about VT/kg among three groups.The serum MMP-9 levels and the MMP-9/TIMP-1 ratio were negatively correlated with TPTEF/TE and VPTEF/VE (r1=-0.459,-0.376; r2=-0.413,-0.327; all P＜0.05).Conclusion The serum levels of MMP-9 and the MMP-9/TIMP-1 ratio in the acute phase of infantile pneumonia are correlated with pneumonia severity and pulmonary function injury in recovery period,and the performance is particularly prominent in the viral pneumonia,and can be used as a prognosis monitoring indicator.