急性发作期支气管哮喘患者血清IL-18、MMP-9、COX-2水平的变化及意义

目的探讨急性发作期支气管哮喘患者血清白细胞介素-18（IL-18）、基质金属蛋白酶-9（MMP-9）、环氧化酶-2（COX-2）水平的变化及意义。方法采用酶联免疫吸附法（ELISA法）检测57例急性发作期支气管哮喘患者（研究组）和46例急性发作期慢性喘息型支气管炎患者（对照组）入院时和缓解期后1个月血清IL-18、MMP-9、COX-2的水平。结果研究组缓解期后1个月血清IL-18、MMP-9、COX-2水平均较入院时明显降低（均P〈0.05）,研究组缓解期后1个月血清IL-18、MMP-9水平均较对照组明显升高,而血清COX-2水平较对照组降低（均P〈0.05）;对照组入院时血清IL-18、MMP-9、COX-2水平与缓解期后1个月比较差异均无统计学意义（均P〉0.05）。相关性分析结果显示：研究组血清COX-2水平与血清MMP-9、IL-18水平均呈正相关（r=0.558、0.625,均P〈0.05）,血清MMP-9水平与血清IL-18水平呈正相关（r=0.432,P〈0.05）。结论 IL-18、MMP-9、COX-2可能参与了哮喘急性发病过程,为新的临床治疗靶点提供了一定的依据,为急性发作期支气管哮喘和急性发作期慢性喘息型支气管炎患者提供了鉴别诊断依据。

Changes in Matrix Metalloproteinase-9, Interleukin-18 and Cyclooxygenase-2 Levels in Patients with Acute Exacerbation of Bronchial Asthma and Their Significance

Objective To investigate the changes in serum levels of interleukin-18（IL-18）,matrix metalloproteinase-9（MMP-9）and cyclooxygenase-2（COX-2）in patients with acute exacerbation of bronchial asthma and their significance.Methods The levels of serum IL-18,MMP-9 and COX-2 were detected by enzyme-linked immunosorbent assay on admission and at 1 month after remission in 57 patients with acute exacerbation of bronchial asthma（study group）and 46 patients with acute exacerbation of chronic asthmatic bronchitis（control group）.Results In study group,levels of serum IL-18,MMP-9 and COX-2 at 1 month after remission were significantly lower than those on admission（all P〈 0.05）.Compared with control group,levels of IL-18 and MMP-9 significantly increased and COX-2 levels obviously decreased at 1 month after remission in study group（all P〈0.05）.In control group,levels of IL-18,MMP-9 and COX-2 at 1 month after remission were not significantly different from those on admission（all P〉0.05）.In study group,levels of IL-18 were positively correlated with levels of MMP-9 and COX-2（r=0.558 and r=0.625,respectively;P〈0.05）,and levels of MMP-9 levels were positively correlated with levels of IL-18（r=0.432,P〈0.05）.Conclusion The levels of IL-18,MMP-9 and COX-2 may be involved in the pathogenesis of acute bronchial asthma.This study provides a basisfor the new clinical therapeutic targets and for the differential diagnosis of acute exacerbation of bronchial asthma and acute exacerbation of chronic asthmatic bronchitis.