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目的:探讨肺结核并发纤维化患者支气管肺泡灌洗液(BALF)及血清中基质金属蛋白9(MMP-9)及基质金属蛋白酶组织抑制剂1(TIMP-1)含量与肺纤维化及肺功能的关系。方法:酶联免疫(ELISA)法检测我院2009年3月至2009年9月68例肺结核并发纤维化患者(纤维化组)及30例无肺部疾病患者(对照组)的支气管肺泡灌洗液及血清中MMP-9及TIMP-1的含量,同时进行肺功能检查。结果:纤维化组患者的BALF及血清MMP-9的含量与对照组患者相比无统计学意义,但纤维化组患者的BALF及血清TIMP-1的含量显著高于对照组(P<0.05),且纤维化组患者的BALF及血清MMP-9/TIMP-1比值低于对照组(P<0.05)。患者的动脉血氧分压、肺活量等肺功能指标与TIMP-1呈正相关,而与MMP-9/TIMP-1比值呈负相关(P<0.05)。结论:肺结核患者肺纤维化的发生可能与TIMP-1水平升高及MMP-9/TIMP-1比值降低相关,降低TIMP-9的水平可能是防止肺结核患者并发肺纤维化的一种新途径。
Objective: To investigate the relationship between bronchial alveolar lavage fluid (BALF), serum matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinase 1 (TIMP-1) and pulmonary fibrosis and pulmonary function in patients with pulmonary tuberculosis complicated with fibrosis relationship. Methods: The bronchial alveolar lavage of 68 patients with pulmonary tuberculosis complicated with fibrosis (fibrosis group) and 30 patients without pulmonary disease (control group) from March 2009 to September 2009 in our hospital were detected by enzyme linked immunosorbent assay (ELISA) Fluid and serum levels of MMP-9 and TIMP-1, at the same time lung function tests. Results: The levels of BALF and serum MMP-9 in patients with fibrosis were not significantly different from those in control group. However, the levels of BALF and serum TIMP-1 in patients with fibrosis were significantly higher than those in control group (P <0.05) , And the ratio of BALF and serum MMP-9 / TIMP-1 in fibrosis group was lower than that in control group (P <0.05). The indexes of pulmonary function such as arterial oxygen tension and vital capacity were positively correlated with TIMP-1 and negatively correlated with the ratio of MMP-9 / TIMP-1 (P <0.05). Conclusions: Pulmonary fibrosis in patients with pulmonary tuberculosis may be related to the increase of TIMP-1 level and the decrease of MMP-9 / TIMP-1 ratio. Reducing the level of TIMP-9 may be a new way to prevent the pulmonary fibrosis in patients with pulmonary tuberculosis.