MMP-9及TIMP-1在儿童闭塞性细支气管炎的表达水平及临床意义
发布时间：2018-03-30 18:17
本文选题：MMP-9 切入点：TIMP-1 出处：《广州医科大学》2014年硕士论文
【摘要】：目的通过研究感染后闭塞性细支气管炎患儿肺泡灌洗液及血液中基质金属蛋白酶-9(MMP-9)及基质金属蛋白酶抑制物-1(TIMP-1)的表达水平，探讨MMP-9、TIMP-1和MMP-9/TIMP-1在儿童感染后闭塞性支气管炎的临床意义。 方法采用酶联免疫分析法（ELISA）分别测定13例感染后闭塞性细支气管炎与10例支气管异物对照组灌洗液中和13例感染后闭塞性细支气管炎及13例正常对照组血液中的MMP-9、TIMP-1表达水平。 结果与支气管异物对照组(131.33±43.93)相比,闭塞性细支气管炎(2732.81±599.57)肺泡灌洗液中MMP-9的表达水平明显增高（P0.01）；与正常组（1160.34±273.75）相比，闭塞性细支气管炎组（2872.15±737.04）血中MMP-9表达水平明显增高(P0.05)；与支气管异物对照组相比（211.56±41.04)相比,闭塞性细支气管炎组(144.55±24.84)肺泡灌洗液中TIMP-1的表达水平无明显差异（P0.05）；与正常组（257.60±12.45）相比，闭塞性细支气管炎组（268.79±15.307）血中TIMP-1表达水平无明显差异(P0.05)；与对照组相比（0.50±0.13；4.90±1.29）,闭塞性细支气管炎灌洗液及血液中MMP-9/TIMP-1（14.71±2.53；11.14±2.78）的比率明显升高（P0.01；P0.05）。 结论在儿童感染后闭塞性细支气管炎，MMP-9在灌洗液及血液中表达明显增高;MMP-9/TIMP-1比率明显升高.提示MMP-9可能参与儿童感染后闭塞性细支气管炎的致病机制，MMP-9/TIMP-1比率失衡可能在儿童感染后闭塞性细支气管气道纤维化及重塑起重要作用。 目的通过分析儿童闭塞性细支气管炎支气管镜活检(TBLB)组织学特点，，结合临床和影像表现，提高对本病的认识、诊断及鉴别诊断。 方法回顾性分析13例经临床诊断证实BO患儿的临床表现和支气管镜活检(TBLB)表现及高分辨CT资料，男10例,女3例，年龄从9月-38个月，平均年龄25.3个月，平均病程8个月,所有患儿均为肺部感染或肺损伤后反复或持续喘息、气促、咳嗽或者喘鸣且症状均持续时间＞6周。13例均肺部高分辨率CT（HRCT）检查，并行支气管镜活检术(TBLB)。13例进行诱导痰细胞学检查。因BO患儿年龄较小，均未行肺功能检查。 结果患者均有较典型的临床表现，HRCT表现：马赛克征13例（100㳠）；斑点或斑片状模糊影9例（76㳠）；支气管壁增厚3例（23㳠）；含气不全或肺实变不张3例（23㳠）；支气管扩张症2例（15㳠）；钙化灶1例（7㳠）。3例行支纤镜检查显示气管、支气管内膜炎症。TBLB取得肺组织学或细支气管病理改变为：细支气管周围炎症13例（100㳠）；细支气管管壁纤维化11例（85㳠）；上皮细胞坏死脱落7例（53㳠）,邻近肺泡炎症或萎缩6例（18㳠）；9例中性粒细胞增高，其中7例明显增高（≥60％）,余4例因细胞总数不达标未能检出。. 结论细支气管粘膜炎症及增厚同时伴有细支管壁纤维化、官腔内上皮细胞的脱落是儿童BO TBLB组织活检较特征的表现，同时结合患儿临床表现和胸部HRCT、支气管镜检查可以明显提高BO与其他疾病诊断和鉴别诊断，并可在治疗随访后最终确诊。
[Abstract]:Objective to study the expression of matrix metalloproteinase-9 (MMP-9) and matrix metalloproteinase-1 inhibitor (TIMP-1) in alveolar lavage fluid and blood of children with bronchiolitis obliterans after infection. To investigate the clinical significance of MMP-9 TIMP-1 and MMP-9/TIMP-1 in children with obstructive bronchitis. Methods the expression of MMP-9 TIMP-1 in 13 cases of bronchiolitis obliterans after infection and 10 cases of bronchiolitis obliterans, 13 cases of bronchiolitis obliterans after infection and 13 cases of normal controls were detected by enzyme linked immunosorbent assay (Elisa). Results compared with bronchial foreign body control group (131.33 卤43.93), the expression of MMP-9 in bronchiolitis obliterans (2732.81 卤599.57) was significantly higher than that in control group (P 0.01) and in normal group (1160.34 卤273.75). The expression of MMP-9 in bronchiolitis obliterans group (2872.15 卤737.04) was significantly higher than that in bronchiolitis group (211.56 卤41.04), and that in bronchiolitis obliterans group (144.55 卤24.84) was not significantly different from that in bronchiolitis group (257.60 卤12.45). There was no significant difference in the expression of TIMP-1 in the blood of the bronchiolitis obliterans group (268.79 卤15.307), but the ratio of MMP-9/TIMP-1(14.71 卤2.53 卤11.14 卤2.78 in the lavage fluid and blood of bronchiolitis obliterans was significantly higher than that in the control group (0.50 卤0.13 卤4.90 卤1.29). Conclusion in children with bronchiolitis obliterans, the expression of MMP-9 is significantly increased in lavage fluid and blood. It is suggested that MMP-9 may be involved in the pathogenesis of bronchiolitis obliterans after infection and the imbalance of MMP-9 / TIMP-1 ratio. It may play an important role in bronchiolobronchial fibrosis and remodeling after infection in children. Objective to improve the understanding, diagnosis and differential diagnosis of bronchiolitis obliterans by analyzing the histological features of TBLB in children with bronchiolitis obliterans. Methods the clinical manifestations, TBLB findings and high resolution CT findings of 13 children with BO confirmed by clinical diagnosis were retrospectively analyzed. There were 10 males and 3 females, aged from September to 38 months, with an average age of 25.3 months and an average course of disease of 8 months. All the children had repeated or continuous wheezing after pulmonary infection or lung injury, shortness of breath, cough or wheezing, and the symptoms lasted more than 6 weeks. 13 cases of TBLBU were examined by inductive sputum cytology because of their younger age and no pulmonary function examination was performed. Results all the patients had typical clinical manifestations: mosaic sign (13 cases) and HRCT (100 cases). Mottled or patchy blur in 9 cases? Bronchial wall thickening: 3 cases: 23? Qi-containing incompleteness or pulmonary atelectasis: 3 cases: 23? Bronchiectasis: a report of 2 cases. Calcification: 1 case: 7? Bronchofiberscope examination showed that bronchial endobronchial inflammation. TBLB obtained lung histology or bronchiole pathological changes: bronchiolitis in 13 cases or 100? Bronchiole wall fibrosis: report of 11 cases. 7 cases of epithelial cell necrotic exfoliation? Adjacent alveolar inflammation or atrophy in 6 cases. Neutrophils were increased in 9 cases, of which 7 cases were significantly increased (鈮
本文编号：1687065
本文链接：https://www.wllwen.com/yixuelunwen/eklw/1687065.html
最近更新
教材专著
