肝病大鼠创伤弧菌脓毒症基质金属蛋白酶-9的动态变化  

Dynamic changes of serum matrix metalloproteinase-9 （MMP-9） and its significance in rat model of alcoholic liver disease with Vibrio vulnificus sepsis

作　　者：卢中秋[1] 邱俏檬[1] 周铁丽[2] 洪广亮[1] 梁欢[1] 吴斌[1] 

机构地区：[1]温州医学院第一附属医院急诊科,浙江省温州325000 [2]温州医学院第一附属医院临检中心,浙江省温州325000

出　　处：《中华急诊医学杂志》2008年第3期244-247,共4页Chinese Journal of Emergency Medicine

基　　金：浙江省科技厅科研基金资助项目（2005C30009）;浙江省医学扶植重点建设学科技划（07-F04）

摘　　要：目的探讨血清MMP-9水平与酒精性肝病大鼠创伤弧菌脓毒症进展的关系。方法制作酒精性肝病大鼠创伤弧菌脓毒症模型，分脓毒症组及抗菌药物干预组。观察脓毒症组大鼠在染菌后2h、6h、12h、24h各时间点的脓毒症表现及光镜下肺组织病理改变，并以ELISA法测定脓毒症组及抗菌药物干预组大鼠染菌后各时间点血清MMP-9水平。计量资料采用（X^-±s）表示。采用SPSS10．0进行统计，各组血清MMP-9值作t检验，多组间差异采用单因素方差分析处理。P〈0．05为差异有统计学意义。结果脓毒症组大鼠染菌后6h开始出现较明显的毒血症状，并随时间的延长加剧，24h达高峰，濒临死亡。光镜下肺组织损伤以炎症细胞浸润及肺泡壁水肿充血为主，6h较轻，12h损伤加重，到24h可见大量的炎细胞浸润，淋巴滤泡形成，伴肺泡腔出血。脓毒症组血清MMP-9水平染菌后6h明显升高（P〈0．01），12h达高峰，24h已明显下降（P〈0．01，与12h组比）。抗菌药物干预组大鼠血清MMP-9变化曲线与脓毒症组一致，但与脓毒症组相应时间点比较，仅6h时MMP-9水平明显减低（P〈0．01）。结论MMP-9可能不是酒精性创伤弧菌脓毒症后期病情恶化的主要参与因素，血清MMP-9水平不能准确地反应酒精性肝病创伤弧菌脓毒症病情轻重及全身器官损伤的程度。Objective To investigate the relationship between the levels of serum matrix metalloproteinase- 9 （MMP-9） and vibrio vulnificus sepsis in rat medol of alcoholic liver disease. Method After the vibrio vulnificus sepsis models set up in Sdrats with alcoholic liver desease, the models were divided into sepsis and antibacterial group. The signs of sepsis and the pathomorphology of lung were observed successively in rats of sepsis group 2 h, 6 h, 12 h and 24 h after iunoculation with vibrio vulnificus, and the levels of serum MMP-9 were tested by enzyme linked immunosorbent assay （ELISA） in rats of beth groups at the different intervals after innoculation. Results In sepsis group, the toxemic symptoms of sepsis became apparent 6 h after innoculation, aggravated at 12 h, and got the nearly dead situation at 24 h. And lungs injuried by congestion, hemorrhage and inflammatory cells infiltration became more and more severe after innoculation. Compared with control group, the levels of MMP-9 in rats of sepsis group were increased markedly at 6 h （ P 〈 0.01）, and peaked at 12 h. However, it declined at 24 h （ P 〈 0.001, compared with 12 h）. The changes of serum MMP-9 in the rats of antibacterial group showed similar trend to that of sepsis group, but the levels of serum MMP-9 in antibacterial group was lower than those in sepsis group with statistically significant differences at 6h （ P 〈 0.01 ）. Conclusions MMP-9 is not a vital factor which gets involved in the late pathogenesis of vibrio vulniticus sepsis. Therefore, the serum MMP-9 is not good enough as an biomarker used to assess the pathogenetic setting resulted from vibrio vulnificus sepsis and the degree of organ danmge.

关 键 词：脓毒症 创伤弧菌 病理形态学 毒血症状 基质金属蛋白酶-9 

分 类 号：R575[医药卫生—消化系统] R735.2[医药卫生—内科学]