目的 观察特发性肺间质纤维化(IPF)患者血清基质金属蛋白酶-2(MMP-2)、基质金属蛋白抑制因子(TIMP-1)及Ⅳ型胶原(Ⅳ-C)含量及激素治疗前后对其影响.方法 选择50例IPF患者及15例健康对照人群,测定IPF患者及对照组血清MMP-2、TIMP-1及Ⅳ-C水平;IPF患者予口服激素治疗,据IPF患者治疗后临床症状缓解程度,判定为治疗有效组或无效组,比较2组治疗前后血清MMP-2、TIMP-1及Ⅳ-C水平变化.结果 IPF患者治疗前血清MMP-2、TIMP-1及Ⅳ-C含量高于对照组(P<0.05);有效组治疗前血清MMP-2、MMP-2/TIMP-1高于无效组,血清TIMP-1及Ⅳ-C水平低于无效组(P<0.05);有效组治疗后血清MMP-2较治疗前及无效组下降,血清TIMP-1及Ⅳ型胶原治疗前后变化差异无统计学意义(P>0.05),无效组血清MMP-2、TIMP-1及Ⅳ-C水平治疗前后变化差异无统计学意义(P>0.05).结论 治疗前血清MMP-2高可以提示对激素治疗反映较好,血清TIMP-1及Ⅳ-C高,提示激素治疗疗效较差.%Objective To investigate the effect of hormone therapy on the serum levels of matrix matalloproteinase-2 ( MMP-2 ), tissue inhibitor of metalloproteinase-1 ( TIMP-1 ) and type IV collagen in patients with idiopathic pulmonary interstitial fibrosis ( IPF ). Methods The 50 patients with IPF and 15 healthy subjects ( control group ) were enrolled in the study, and the serum levels of MMP-2, TIMP-1 and type IV collagen were detected for all the patients and healthy subjects. The patients were treated by oral hormones, then the patients were divided into efficiency group and no efficiency group according to the relief extent of clinical symptoms, and the changes of serum levels of MMP-2, TIMP-1 and type IV collagen before and after treatment were detected and compared. Results Before treatment the serum levels of MMP-2,TIMP-1 and type IV collagen in patients with IPF were significantly higher than those of healthy subjects ( P <0. 05 ). Before treatment the serum levels of MMP-2 and the ratio of MMP-2/TIMP-1 in efficiency group were higher than those of no efficiency group, however, the serum levels of TIMP-1 and type IV collagen in efficiency group were significantly lower than those of no efficiency group ( P <0. 05 ); after treatment the serum levels of MMP-2 in efficiency group were decreased, as compared with those before treatment and with those in no efficiency group, but there were no significant differences in the serum levels of TIMP-1 and type IV collagen before treatment and after treatment ( P > 0. 05 ), nor were the serum levels of MMP-2,TIMP-1 and type IV collagen before treatment and after treatment in no efficiency group ( P > 0.05 ). Conclusion The higher levels of serum MMP-2 in patients with IPF may suggest that the therapeutic effect of hormone is better,however,the the higher levels of serum TIMP-1 and type IV collagen may suggest that the therapeutic effect of hormone is worse.
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