呼吸道异物患儿肺泡灌洗液中羟脯氨酸基质金属蛋白酶9及其抑制物水平的研究  

Levels of hydroxyproline,matrix metalloproteinase-9 and its inhibitor in bronchoalveolar lavage fluid of children with airway foreign body aspiration

作　　者：唐兰芳[1] 杜立中[1] 陈志敏[1] 王财富[1] 祝国红[1] 罗社声[1] 鲍兴儿[1] 

机构地区：[1]浙江大学医学院附属儿童医院,杭州310003

出　　处：《中国实用儿科杂志》2005年第8期475-478,共4页Chinese Journal of Practical Pediatrics

摘　　要：目的以肺泡灌洗液(BALF)中羟脯氨酸(HYP)、基质金属蛋白酶9(MMP-9)及其抑制物(TIMP-1)为观察指标,了解呼吸道异物吸入对气道损害、重建的影响.方法对2002年6月至2003年3月在浙江大学儿童医院住院的46例呼吸道异物患儿,按异物滞留体内时间分为3组(A组:<7d,B组:～30d,C组:>30d),对3组患儿的BALF进行细胞学分析,并对其中的HYP、MMP-9细胞阳性率和TIMP-1质量浓度进行测定.对照组为12例有异物吸入可疑病史,但最后排除的儿童.结果对照组与患儿组间细胞学计数差异无显著性(P>0.05),但肥大细胞仅在患儿BALF中发现.对照组及各组患儿的MMP-9细胞阳性率分别为33.3%、62.5%、80.0%和93.3%,TIMP-1细胞阳性率分别为16.3%、50.0%、80.0%和93.3%,总体差异均有显著性意义(P=0.006和P<0.001);各组间HYP差异有显著性意义(P<0.001).结论气道异物促进MMP-9、TIMP-1及HYP的表达和分泌,提示气道异物可导致支气管肺组织破坏和重建,其程度与异物滞留时间有关.Objective To observe the extracellular matrix remodeling on children with airway foreign body aspiration （ FBA ） through detecting the expression of matrix metalloproteinase-9 （ MMP-9 ） , tissue inhibitor of matrix metalloproteinase-1 （TIMP-1 ） ,and hydroxyproline （ HYP） in bronchoalveolar lavage fluid （ BALF）. Methods 12 controls and 46 children with FBA removed via fiberoptic bronchoscopy from 2002 - 2003 were studied in our unit. Patients were divided into 3 subgroups according to the duration of FBA （ subgroup A： 〈7 days; subgroup B-7 -30 days; subgroup C： 〉30 days）. Cell count,levels of MMP-9,TIMP-1 in BALF cells and HYP of BALF was measured. Results The total number of cells and differential cells recovered in BALF did not differ significantly between patients and controls （ P =0. 431 ）. The positive rate of MMP-9 in controls and subgroups of patients were 33.3% ,62. 5% ,80. 0% ,and 93. 3% with a significant difference （ P =0. 006）. The positive rate of T1MP-1 was 16. 3% ,50.0% ,80. 0% ,and 93.3% with a significant difference （ P 〈 0. 001 ）. The differences of HYP in controls and different patients are significant as well （ P 〈 0. 001 ）. There were positive correlations between the MMP-9 ,TIMP-1 ,HYP levels in patients and duration of FB retention （ P 〈0. 05 ）. The levels of MMP-9 and TIMP-1 were also associated with percent of mast cell （ P = 0. 009, P = 0. 005 ）. The differences of MMP-9 and TIMP-1 before and after FB removed were not significant （ P =0. 131, P =0. 522） ,while the HYP levels decreased significantly than that before FB removed （ P = 0. 001 ）. Conclusion MMP-9,TIMP-1 and HYP are significantly elevated in children with FBA and are related to the extracellular matrix remodeling. These changes are irreversible in short time

关 键 词：异物 支气管肺泡灌洗液 基质金属蛋白酶9 羟脯氨酸 基质金属蛋白酶抑制剂1 

分 类 号：R72[医药卫生—儿科]