呼吸道异物患儿肺泡灌洗液中羟脯氨酸基质金属蛋白酶9及其抑制物水平的研究

来源 :中国实用儿科杂志 | 被引量 : 0次 | 上传用户:dsgver5r33
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目的以肺泡灌洗液(BALF)中羟脯氨酸(HYP)、基质金属蛋白酶9(MMP-9)及其抑制物(TIMP-1)为观察指标,了解呼吸道异物吸入对气道损害、重建的影响。方法对2002年6月至2003年3月在浙江大学儿童医院住院的46例呼吸道异物患儿,按异物滞留体内时间分为3组(A组:<7d,B组:~30d,C组:>30d),对3组患儿的BALF进行细胞学分析,并对其中的HYP、MMP-9细胞阳性率和TIMP-1质量浓度进行测定。对照组为12例有异物吸入可疑病史,但最后排除的儿童。结果对照组与患儿组间细胞学计数差异无显著性(P>0.05),但肥大细胞仅在患儿BALF中发现。对照组及各组患儿的MMP-9细胞阳性率分别为33.3%、62.5%、80.0%和93.3%,TIMP-1细胞阳性率分别为16.3%、50.0%、80.0%和93.3%,总体差异均有显著性意义(P=0.006和P<0.001);各组间HYP差异有显著性意义(P<0.001)。结论气道异物促进MMP-9、TIMP-1及HYP的表达和分泌,提示气道异物可导致支气管肺组织破坏和重建,其程度与异物滞留时间有关。 OBJECTIVE To investigate the effects of inhalation of respiratory tract on the damage of airway and the reconstruction of airway by measuring the levels of hydroxyproline (HYP), matrix metalloproteinase 9 (MMP-9) and its inhibitor (TIMP-1) in BALF, Impact. Methods From June 2002 to March 2003, 46 children with respiratory tract foreign bodies admitted to Children’s Hospital of Zhejiang University were divided into 3 groups according to the time of foreign body retention (group A: <7d, group B: ~ 30d, group C: > 30 days). The BALF of 3 groups of children were analyzed by cytology, and the positive rate of HYP and MMP-9 and the concentration of TIMP-1 were determined. The control group was 12 children with suspected history of foreign body aspiration, but finally excluded. Results There was no significant difference in cytological count between control group and children (P> 0.05), but mast cells were only found in BALF of children. The positive rates of MMP-9 in control group and each group were 33.3%, 62.5%, 80.0% and 93.3%, respectively. The positive rates of TIMP-1 cells were 16.3%, 50.0%, 80.0% and 93.3% (P = 0.006 and P <0.001). The difference of HYP between groups was significant (P <0.001). Conclusions Airway foreign bodies promote the expression and secretion of MMP-9, TIMP-1 and HYP, suggesting that airway foreign body can cause the destruction and reconstruction of bronchial lung tissue. The degree of airway foreign body is related to the residence time of foreign body.
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