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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 investigate the effects of inhaled glucocorticoid on the serum levels of matrix metalloproteinase 9 (MMP-9) and matrix metalloproteinase-1 (TIMP-1) in asthmatic children and explore the mechanism of glucocorticoid in reducing airway remodeling. Methods 50 children with asthma. Glucocorticoid letter will be allowed to be insured (budesonide / formoterol powder inhaler), each containing budesonide 80μg, formoterol 4.5μg, 2 times a day for 12 weeks, using ELISA The levels of serum MMP-9, TIMP-1 and the indexes of pulmonary function [maximum second expiratory volume (FEV1), peak expiratory flow velocity (PEF)] were measured before and after inhalation of budesonide / formoterol inhalation Change, and the correlation between the two. Results The serum levels of MMP-9 in asthmatic children decreased from (43.25 ± 13.26) μg.L-1 before inhalation to (29.62 ± 12.47) μg.L-1 after inhaled glucocorticoid budesonide / formoterol powder, 1, the level of TIMP-1 increased from (119.88 ± 32.56) μg.L-1 to (143.15 ± 45.36) μg.L-1 before inhalation, with statistical significance (Pa0.01). The percentages of PEF and FEV1 were predicted to increase from (76.15 ± 3.26)% and (73.12 ± 4.63)% before inhalation to (85.42 ± 4.73)% and 86.49 ± 3.72%, respectively The percentages were negatively correlated with the ratio of MMP-9 / TIMP-1 (r = -0.402, -0.364, Pa <0.05). Conclusion Glucocorticoid can interfere with the occurrence of respiratory remodeling by regulating the balance of MMP-9 / TIMP-1 and reducing collagen deposition.