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目的探讨特发性肺纤维化(IPF)患者支气管肺泡灌洗液(BALF)及血清中基质金属蛋白酶9(MMP9)、基质金属蛋白酶组织抑制剂1(TIMP1)水平的变化。方法2001至2004年用酶联免疫吸附(ELISA)法检测30例IPF患者BALF及血清中MMP9和TIMP1的水平,同时行肺高分辨率CT(HRCT)及肺功能检查。健康非吸烟的自愿献血者30名,为血清对照组。以胸痛为自觉症状在我院自愿进行纤维支气管镜及BALF检查,经体检及X线检查证实为健康者13名,作为BALF对照组。结果IPF患者BALF及血清中MMP9水平为(245±26)和(203±32)ng/L,对照组为(205±22)和(186±16)ng/L,两组相比差异无统计学意义;IPF组BALF及血清中TIMP1水平[(522±81)、(166±29)ng/L]高于对照组[(201±31)、(87±16)ng/L],差异有统计学意义;IPF组BALF及血清中MMP9/TIMP1比值(0.53±0.18,1.5±0.3)低于对照组(1.06±0.38,2.6±0.5)。HRCT、肺功能评分及BALF中上述指标与MMP9无明显相关性,与TIMP1呈正相关,与MMP9/TIMP1比值呈负相关。结论IPF患者肺纤维化的发生与TIMP1水平升高及MMP9/TIMP1比值降低对细胞外基质降解的抑制有关,后者可能意义更大;患者肺影像学及肺功能变化可能也与此有关。
Objective To investigate the changes of bronchial alveolar lavage fluid (BALF) and serum levels of matrix metalloproteinase 9 (MMP9) and tissue inhibitor of metalloproteinase 1 (TIMP1) in patients with idiopathic pulmonary fibrosis (IPF). Methods From 2001 to 2004, the levels of MMP9 and TIMP1 in BALF and serum of 30 patients with IPF were detected by enzyme-linked immunosorbent assay (ELISA). High resolution lung CT (HRCT) and pulmonary function tests were also performed. 30 healthy non-smoking voluntary blood donors, as serum control group. To chest pain as symptoms in our hospital voluntarily bronchoscopy and BALF examination, physical examination and X-ray examination confirmed that 13 healthy people, as the BALF control group. Results The levels of MMP9 in BALF and serum were (245 ± 26) and (203 ± 32) ng / L in patients with IPF and (205 ± 22) and (186 ± 16) ng / L in controls, respectively The level of TIMP1 in BALF and serum in IPF group was significantly higher than that in control group [(522 ± 81), (166 ± 29) ng / L] [(201 ± 31), (87 ± 16) ng / L] Statistical significance; IPF group BALF and serum MMP9 / TIMP1 ratio (0.53 ± 0.18,1.5 ± 0.3) lower than the control group (1.06 ± 0.38,2.6 ± 0.5). HRCT, pulmonary function score and BALF in the above indicators and MMP9 no significant correlation with TIMP1 was positively correlated with MMP9 / TIMP1 ratio was negatively correlated. Conclusions The occurrence of pulmonary fibrosis in patients with IPF is related to the increase of TIMP1 level and the decrease of MMP9 / TIMP1 ratio on the inhibition of extracellular matrix degradation, which may be more significant. The changes of lung imaging and pulmonary function may also be related to this.