儿童肾盂输尿管连接部梗阻患者尿液中MMP-7和MMP-9的临床意义  

Evaluation of matrix metalloproteinase-7 and matrix metalloproteinase-9 as biomarkers in ureteropelvic junction obstruction in children:a preliminary report

作　　者：秦双利 谢崇 周玲[1] 刘璇 刘妍芳[1] 余亮[1] 李凯[1] Qin Shuangli;Xie Chong;Zhou Ling;Liu Xuan;Liu Yanfang;Yu Liang;Li Kai(Department of Pediatric Surgery,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xin Jiang,830000,China;Xi'an International Medical Center Hospital,Shaanxi Province,710000,China.)

机构地区：[1]新疆维吾尔自治区人民医院小儿外科,新疆乌鲁木齐市830000 [2]西安国际医学中心医院,陕西省西安市710000

出　　处：《临床小儿外科杂志》2021年第7期664-667,共4页Journal of Clinical Pediatric Surgery

基　　金：新疆维吾尔自治区自然科学基金资助项目基金(编号:2019D01C112)。

摘　　要：目的探讨尿液中MMP-7和MMP-9对儿童肾盂输尿管连接部梗阻(ureteropelvic junction obstruction,UPJO)的诊断价值。方法本研究共纳入新疆维吾尔自治区人民医院24例单侧UPJO患者作为病例组,其中左侧18例、右侧6例,平均年龄5.8岁(37天至15岁),20例完成肾动态显像。16例行肾盂输尿管成形术(为手术组),余8例为非手术组;另纳入16例健康儿童作为对照组。随访时间为术后6个月至1年,随访项目包括超声、尿液MMP-7和MMP-9水平。结果病例组尿中MMP-7/尿肌酐和MMP-9/尿肌酐水平高于对照组(P<0.05);手术组MMP-7/尿肌酐和MMP-9/尿肌酐水平均高于非手术组(P<0.05);10例获随访患者术前MMP-7/尿肌酐和MMP-9/尿肌酐水平均高于术后组(P<0.05)。不同肾积水程度患者的MMP-7/尿肌酐和MMP-9/尿肌酐水平值比较,差异无统计学意义(P>0.05)。MMP-7/尿肌酐、MMP-9/尿肌酐与肾GFR无相关性(r=-0.128,P=0.592;r=-0.157,P=0.507)。结论与健康儿童相比,单侧UPJO患者尿液中MMP-7、MMP-9水平明显升高,行手术治疗者MMP-7/尿肌酐和MMP-9/尿肌酐水平显著高于非手术治疗者,术后6个月患者尿液中MMP-7、MMP-9水平较术前下降。Objective To evaluate the application values of urinary matrix metalloproteinase-7(MMP-7)and matrix metalloproteinase-9(MMP-9)as biomarkers in children with ureteropelvic junction obstruction(UPJO).Methods A total of 24 children with unilateral UPJO were recruited along with another 16 healthy controls.The involved side was left(n=18)and right(n=6).And the average age was 5.8 years(37 days to 15 years).Among them,20 children received 99mTc-DTPA(diethylenetriaminepentaacetic acid)renal dynamic imaging and another 16 underwent pyeloplasty.Quantitative urinary protein analysis was performed and urinary creatinine level employed for normalizing protein levels for the biomarkers.Results The creatinine-normalized urinary levels of MMP-7/MMP-9 protein were higher in UPJO children than healthy controls(P<0.05).Moreover,urinary levels of MMP-7/MMP-9 protein were higher in operation group than those in non-operation group.The preoperative levels of MMP-7/MMP-9 protein in 10 children were higher than those post-operation(P<0.05).No significant differences existed in creatinine-normalized urinary levels of MMP-7/MMP-9 in varying degrees of hydronephrosis(P>0.05).And normalized levels of MMP-7/MMP-9 were not correlated with glomerular filtration rate of affected side(r=-0.128,P=0.592;r=-0.157,P=0.507).Conclusion Compared with healthy children,urinary levels of MMP-7/MMP-9 of children with unilateral UPJO were significantly higher.The levels of MMP-7/MMP-9 proteins were also significantly higher in operation group than those in non-operation group and the levels of MMP-7/MMP-9 protein declined during follow-ups at Month 6 post-operation.

关 键 词：基质金属蛋白酶7/分析 基质金属蛋白酶9/分析 肾盂积水 肾盂输尿管连接部梗阻/诊断 

分 类 号：R726.921.7[医药卫生—儿科]