早期分泌抗原靶6及基质金属蛋白酶9评估结核性毁损肺严重程度的应用价值  

Application value of ESAT-6 combined with MMP-9 in assessing the severity of tuberculosis destroyed lung

作　　者：陆霓虹 孙娅萍 金媛 夏加伟 杨永锐 LU Ni-hong;SUN Ya-ping;JIN Yuan;XIA Jia-wei;YANG Yong-rui(Department of Respiratory and Critical Care Medicine,the Third People’s Hospital of Kunming,Kunming 650041,China)

机构地区：[1]昆明市第三人民医院呼吸与危重症医学科,650041 [2]昆明市第三人民医院重症医学科,650041 [3]昆明市第三人民医院科教科,650041

出　　处：《中国防痨杂志》2021年第2期139-142,共4页Chinese Journal of Antituberculosis

基　　金：云南省科技厅高校联合面上项目(2018FH001-077);昆明市科技计划重点项目(昆科计字2019-1-N-25318000003253);云南省地方高校联合专项重点项目(202001BA070001-011)。

摘　　要：目的探讨早期分泌抗原靶6(early secretory antigen target-6,ESAT-6)及基质金属蛋白酶9(matrix metalloproteinase-9,MMP-9)评估结核性毁损肺严重程度中的应用价值。方法选取2018年1月至2019年1月昆明市第三人民医院收治的55例结核性毁损肺患者(A组),40例继发性肺结核患者(B组),以及同期在本院进行体检的健康志愿者20名(C组)作为研究对象,收集研究对象临床资料及实验室检查结果,比较和分析各组ESAT-6、MMP-9水平[中位数(四分位数)]及T淋巴细胞计数[中位数(四分位数)]的变化情况。结果A组ESAT-6表达水平为28.83(19.26,38.20)pg/ml,B组为22.26(17.85,25.01)pg/ml,均明显高于C组[0.06(0.03,1.50)pg/ml],差异均有统计学意义(U=63.155,P<0.01;U=49.725,P<0.01)。A组MMP-9表达水平为12.54(9.01,18.11)μg/ml,明显高于B组的6.80(4.10,12.29)μg/ml和C组的1.14(0.72,1.29)μg/ml,差异均有统计学意义(U=26.097,P<0.01;U=66.309,P<0.01)。所有入组肺结核患者(A组和B组)ESAT-6的表达量水平为24.05(18.54,34.89)pg/ml与CD4^(+)T淋巴细胞计数[476.00(312.00,647.00)个/μl]和CD3+T淋巴细胞计数[599.00(456.00,762.00)个/μl]呈负相关关系(r=-0.462,P<0.01;r=-0.275,P=0.003);MMP-9表达水平为11.05(6.30,14.28)μg/ml,与CD4^(+)和CD3+T淋巴细胞计数也呈负相关关系(r=-0.499,P<0.01;r=-0.341,P<0.01)。A组中重度通气功能障碍者(52.7%,29/55)MMP-9表达水平[10.79(7.10,12.54)μg/ml]明显低于极重度通气功能障碍者(47.3%,26/55)MMP-9表达水平[17.39(12.47,33.30)μg/ml],差异有统计学意义(U=150.000,P<0.01)。结论ESAT-6与MMP-9在肺结核患者中表达增高,与患者免疫功能相关。MMP-9水平与结核性毁损肺严重程度相关。Objective To explore the application value of early secretory antigen target-6(ESAT-6)and matrix metalloproteinase-9(MMP-9)in evaluating the severity of tuberculous damage to the lung.Methods From January 2018 to January 2019,55 patients with tuberculosis-destroyed lung(group A),40 patients with secondry tuberculosis pulmonary(group B)and 20 healthy volunteers with physical examination(group C)were selected from the Third People’s Hospital of Kunming.The clinical data and laboratory examination results were collected,and the level(M(Q1,Q3))of ESAT-6,MMP-9 and immune function were compared among the groups.Results The expression level of ESAT-6 were 28.83(19.26,38.20)pg/ml in group A,22.26(17.85,25.01)pg/ml in group B,which were both significantly higher than that in group C(0.06(0.03,1.50)pg/ml;U=63.155,P<0.01;U=49.725,P<0.01).The expression level of MMP-9 in group A was 12.54(9.01,18.11)μg/ml,which was significantly higher than those in group B(6.80(4.10,12.29)μg/ml)and group C(1.14(0.72,1.29)μg/ml;U=26.097,P<0.01;U=66.309,P<0.01).The expression level of ESAT-6 in pulmonary tuberculosis patients(group A and group B)was 24.05(18.54,34.89)pg/ml,which was negatively correlated with the count of CD4^(+)T lymphocytes(476.00(312.00,647.00)cells/μl and CD3+T lymphocytes(599.00(456.00,762.00)cells/μl;r=-0.462,P<0.01;r=-0.275,P=0.003).The expression of MMP-9 was 11.05(6.30,14.28)μg/ml,which was negatively correlated with the count of CD4^(+)and CD3+T lymphocytes(r=-0.499,P<0.01;r=-0.341,P<0.01).In group A,the expression of MMP-9(10.79(7.10,12.54)μg/ml)in moderate and severe ventilatory dysfunction patients(52.7%,29/55)was significantly lower than that in very severe ventilatory dysfunction patients(47.3%(26/55);17.39(12.47,33.30)μg/ml;U=150.000,P<0.01).Conclusion The expression of ESAT-6 and MMP-9 increased in pulmonary tuberculosis patients,which was related to immune function.The level of MMP-9 was related to the severity of tuberculous damage to the destroyed lung.

关 键 词：细菌蛋白质类 基质金属蛋白酶9 结核 肺 评价研究 

分 类 号：R521[医药卫生—内科学]