摘要
目的 探讨血清基质金属蛋白酶（MMP-9）水平在早期（sepsis）脓毒症患者诊断的参考价值和预后判断意义。方法根据脓毒症及全身炎症反应综合征（SIRS）诊断标准，依据104例重症患者24h病情变化，分成三组：A组（sepsis组）44例；B组（SIRS组）36例；C组（非SIRS组）24例。检测患者转人ICU后2h内血清MMP-9浓度及各项临床指标，探讨其与病情严重程度间相关性，并对影响患者病情严重程度的危险因素进行回归分析。结果①A、B、C组患者MMP-9平均水平依次为（6．46±0．58）mg／L、（6．01±0．71）mg／L、（5．22±0．73）mg／L，组间差异均有统计学意义（P〈0．01）。②相关性分析显示，患者MMP-9水平与APACHEⅡ评分、SOFA评分存在正相关（P〈0．01）。③多元有序Logistic回归显示MMP-9指标进入回归方程（P〈0．01）。④ROC分析显示，MMP-9水平对判定重症患者早期脓毒症发生与否的曲线下面积达0．780（P〈0．01）。结论重症患者血清MMP-9水平测定对于脓毒症发生的早期识别、判断具有一定的临床价值，提示MMP-9可能在脓毒症的发生发展过程中起着重要作用。
Objective To study the clinical significance of the concentrations of MMP -9 in serum of patients with early sepsis. Methods 104 critical ills were admited in ICU during 2010.6 to 2011. 2. According to criterias of Sepsis/SIRS, the patients were divided into three groups： group A, sepsis, 44 cases; group B, SIRS, 36 cases; group C, non - SIRS, 24 cases. The MMP -9 in serum of patients was measured during 2 h adimission in ICU. The disease severity within 24 hours was statistically analysed. Results ①The average level of MMP - 9 in group A, B, C were （6.46±0. 53） mg/L, （6.01± 0.71 ）mg/L, （5.22 ±0.73 ）mg/L respectively and they were significantly different （P 〈0.01 ）. ②Correlation analysis showed that MMP- 9 levels in patients were connected with the scores of APACHE Ⅱ and SOFA （P 〈 0.01 ）. ③Ordered Multiple Logistic Regression on disease severity showed that MMP-9 indicator was into the regression equation （P 〈0.01 ）. ④ROC analysis showed that early MMP -9 levels of patients were helpful to determine the occurrence of sepsis and the area under the curve which was 0. 780 （P 〈 0.01 ）. Conclusion The measurement of MMP - 9 was helpful in the identification of early sepsis and to determine disease severity of critically ills. MMP - 9 may make significant impact on the pathological process of sepsis.
出处
《中国急救医学》
CAS
CSCD
北大核心
2011年第12期1072-1075,共4页
Chinese Journal of Critical Care Medicine
