吸入糖皮质激素对支气管哮喘患儿血清基质金属蛋白酶9及基质金属蛋白酶抑制物1的影响  

Influence of Glucocorticoid on Serum Matrix Metalloproteinase 9 and Tissue Inhibitor of Matrix MetaIloproteinase 1 in Children with Bronchial Asthma

作　　者：李志鸿[1] 任颖[1] 陈爱斌[1] 顾勇[1] 

机构地区：[1]皖南医学院附属弋矶山医院儿科,安徽芜湖241001

出　　处：《实用儿科临床杂志》2011年第21期1654-1655,1688,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的观察吸入糖皮质激素对支气管哮喘(哮喘)患儿血清基质金属蛋白酶9(MMP-9)及基质金属蛋白酶抑制物1(TIMP-1)的影响,探讨糖皮质激素降低呼吸道重塑的机制。方法哮喘患儿50例。给予糖皮质激素信必可都保(布地奈德/福莫特罗粉吸入剂),每吸含布地奈德80μg、福莫特罗4.5μg,每日2次,疗程12周,采用ELISA法测定布地奈德/福莫特罗粉吸入剂吸入前后,血清MMP-9、TIMP-1水平及肺功能指标[第1秒最大呼气量(FEV1)、最大呼气流速峰值(PEF)]的变化,并对二者进行相关性分析。结果使用吸入糖皮质激素布地奈德/福莫特罗粉剂后,哮喘患儿血清MMP-9水平由吸入前的(43.25±13.26)μg.L-1下降至(29.62±12.47)μg.L-1,TIMP-1由吸入前的(119.88±32.56)μg.L-1上升至(143.15±45.36)μg.L-1,差异均有统计学意义(Pa<0.01)。PEF及FEV1变异占预计值百分比分别由吸入前的(76.15±3.26)%,(73.12±4.63)%,上升至(85.42±4.73)%,(86.49±3.72)%,PEF及FEV1变异占预计值百分比与MMP-9/TIMP-1比率均呈负相关(r=-0.402、-0.364,Pa<0.05)。结论糖皮质激素可通过调节MMP-9/TIMP-1的平衡,降低胶原沉积,从而干预呼吸道重塑的发生。Objective To observe the influence of glucocerticoid on matrix metalloproteinase 9 （ MMP - 9） and tissue inhibitor of matrix metalloproteinase 1 （TIMP- 1）in serum from children with asthma, and discuss the mechanism of glucocorticoid in reducing airway remodeling. Methods Fifty children with asthma received inhaled glucocorticoid（budesonide and formoterol fumarate powder for inhalation） therapy for 12 week,80.0 μg budesonide/in and 4.5 μg formoterol/in,2 times a day,using enzyme -linked immunosorbent assay （ELISA） method to detect the levels of MMP - 9 and TIMP - 1 in serum and before and after inspire glucocorticoid, and analyze the correlation with pulmonary function. Results Before and after inspire treatment, MMP - 9 and TIMP - 1 levels in serum were as follows ： MMP - 9 were （ 43.25 ± 13.26） μg.L^- 1 and （29.62 ±12.47 ） Ixg ~ L- 1 ; TIMP - 1 were （ 119.88 ± 32.56 ） μg. L^-1 and （ 143.15±45.36 ） μg.L^- 1, the levels of MMP - 9, TIMP - 1 reduced significantly （ P 〈 0.01 ）, PEF, FEV1 had negative correlation with the ratio of MMP - 9/TIMP - 1 （ r = - 0. 402, - 0. 364, P 〈 0.05 ）. Conclusions The imbalance of MMP - 9/TIMP - 1 ratios may be exist in the progress of asthma. Regulating the balance between MMP - 9 and TIMP - 1 by steroids may be one of the mechanisms by which airway inflammation and remodeling are in- hibited in asthma.

关 键 词：支气管哮喘 基质金属蛋白酶 基质金属蛋白酶抑制物 糖皮质激素 儿童 

分 类 号：R725.6[医药卫生—儿科]