慢性阻塞性肺疾病合并骨質(zhì)疏松患者血清MMP-9、TNF-α與骨代謝異常的相關性研究

李勇輝430100湖北省武漢市蔡甸區(qū)玉賢鎮(zhèn)衛(wèi)生院

慢性阻塞性肺疾病合并骨質(zhì)疏松患者血清MMP-9、TNF-α與骨代謝異常的相關性研究

李勇輝
430100湖北省武漢市蔡甸區(qū)玉賢鎮(zhèn)衛(wèi)生院

目的：分析研究慢性阻塞性肺疾病合并骨質(zhì)疏松患者血清MMP-9、TNF-α與骨代謝異常的相關性。方法：2013-2014年收治慢性阻塞性肺疾病合并骨質(zhì)疏松患者60例，分為骨質(zhì)疏松組、骨密度減低組以及骨密度正常組，每組20例，實行酶聯(lián)免疫吸附試驗法來檢測各組患者血清MMP-9、TIMP-1、TNF-α，并且測算MMP-9/ TIMP-1的值。結果：骨密度正常組、骨密度減低組以及骨質(zhì)疏松組患者的血清MMP-9分別為(33.5±7.1)μg/L、(49.2±6.2)μg/L、(84.6±6.2)μg/L，TNF-α分別為(30.6±10.2)μg/L、(35.2±6.2)μg/L、(40.1±5.6)μg/L，MMP-9/TIMP-1的值分別為(0.20±0.05)、(0.28±0.11)、(0.45±0.13)，并且3組患者隨著骨密度的降低，MMP-9、TNF-α、MMP-9/TIMP-1呈升高趨勢，差異具有統(tǒng)計學意義(P＜0.05)。而3組患者在TIMP-1差異較小，無統(tǒng)計學意義(P＞0.05)。結論：慢性阻塞性肺疾病合并骨質(zhì)疏松患者的骨代謝異常和血清MMP-9、TNF-α具有相關性，并且骨質(zhì)密度越低，血清MMP-9、TNF-α越高。所以血清MMP-9、TNF-α可能在慢性阻塞性肺疾病合并骨質(zhì)疏松患者中發(fā)揮作用，促使患者骨密度下降并導致患者骨代謝異常，應當加強臨床上的干預治療。

慢性阻塞性肺疾病合并骨質(zhì)疏松；血清MMP-9、TNF-α；骨代謝異常

資料與方法

2013-2014年收治慢性阻塞性肺疾病并骨質(zhì)疏松患者60例，以上患者均經(jīng)過嚴格的醫(yī)學檢查，并且病情穩(wěn)定，在排除了身體器質(zhì)性病變和嚴重并發(fā)癥的前提下，所有患者都符合本次試驗研究的標準，并自愿簽署試驗同意書?；颊呔鶠槟行?，主要是為避免女性絕經(jīng)可能會影響試驗的準確性，年齡都＞40歲，根據(jù)患者的骨密度情況，將以上60例患者分為骨質(zhì)疏松、骨密度減低以及骨密度正常3組，每組20例。

方法：在對患者分組之后，首先對患者的病史以及基本信息進行采集記錄，并做好血液采集的工作。在BMD測定上，在患者腰椎以及股骨位置應用吸光測定法來測量BMD。在細胞因子檢測上，使用酶聯(lián)免疫吸附試驗的方法來檢測 患 者 的 血 清 MMP-9、 TIMP-1、TNF-α。

統(tǒng)計學處理：我院采用SPSS 17.0統(tǒng)計軟件進行數(shù)據(jù)的統(tǒng)計處理，計量資料用(±s)來表示，多組間比較用單因素方差來分析，以P＜0.05為差異具有統(tǒng)計學意義。

結果

骨密度正常組、骨密度減低組以及骨質(zhì)疏松組患者的血清MMP-9分別為(33.5±7.1)μ g/L、(49.2±6.2)μ g/L、(84.6±6.2)μg/L，TNF-α分別為(30.6± 10.2)μg/L、(35.2±6.2)μg/L、(40.1±5.6)μg/L，MMP-9/TIMP-1的值分別為(0.20±0.05)、(0.28±0.11)、(0.45± 0.13)，并且3組患者隨著骨密度的降低，MMP-9、TNF-α、MMP-9/TIMP-1呈升高趨勢，差異具有統(tǒng)計學意義(P＜0.05)。而3組患者在TIMP-1差異較小，不具有統(tǒng)計學意義(P＞0.05)，見表1。

Correlation study of serum MMP-9,TNF-αand bone metabolic abnormalities in chronic obstructive pulmonary disease patients with osteoporosis

Li Yonghui
Yuxian Town Health Center of Caidian District,Wuhan City,Hubei Province 430100

Objective:To analyze and study the correlation of serum MMP-9,TNF-αand bone metabolic abnormalities in chronic obstructive pulmonary disease patients with osteoporosis.Methods:60 chronic obstructive pulmonary disease patients with osteoporosis were selected from 2013 to 2014.They were divided into the osteoporosis group,the bone density reducing group and the bone density normal group with 20 cases in each.The serum MMP-9,TIMP-1 and TNF-α of patients in each group were detected by enzyme-linked immunosorbent assay,and MMP-9/TIMP-1 value was calculated.Results:The serum MMP-9 of the bone density normal group,the bone density reducing group and the osteoporosis group were respectively(33.5±7.1)μg/L、(49.2±6.2)μg/L、(84.6±6.2)μg/L;TNF-α were respectively(30.6±10.2)μg/L、(35.2±6.2)μg/L、(40.1±5.6)μg/L; MMP-9/TIMP-1 value were respectively(0.20±0.05)、(0.28±0.11)、(0.45±0.13).And the patients of three groups with the loss of bone density,MMP-9,TNF-α,MMP-9/TIMP-1 showed an increasing trend,and the difference was statistically significant(P＜0.05).And the patients of three groups had small differences in TIMP-1,and the difference was not statistically significant(P＞0.05).Conclusion:The bone metabolic abnormalities of chronic obstructive pulmonary disease patients with osteoporosis has correlation with serum MMP-9,TNF-α,and bone density is lower.The serum MMP-9,TNF-α is higher.So the serum MMP-9,TNF-αmay play a role in chronic obstructive pulmonary disease patients with osteoporosis,promote the bone density loss of patients and lead bone metabolic abnormalities of patients.We should strengthen clinical intervention treatment.

Chronic obstructive pulmonary disease;Serum MMP-9,TNF-α;Bone metabolic abnormalities

10.3969/j.issn.1007-614x.2015.8.64