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目的初步探索血浆MMP-9浓度在早期诊断MODS中的临床应用价值。方法将住院患者按照诊断标准进行筛选后,随机抽取病例,分别纳入损伤组、SIRS组和MODS组,随机抽取体检健康者为对照组。用酶联免疫吸附测定法定量测定血浆MMP9浓度。结果损伤组、SIRS组、MODS组的MMP-9浓度、中性粒细胞数及APACHEⅢ评分,与对照组比较均增高,呈逐级上升趋势。MMP-9水平与中性粒细胞数和APACHEⅢ评分水平均呈正相关。按病程进展,SIRS组分为MODS组和非MODS组,MODS组分为死亡组和存活组,四组比较的结果为病情恶化组患者的MMP-9血浆浓度和APACHEⅢ评分值水平均较非恶化组高,但SIRS组中MODS组与MODS组中存活组的MMP-9均数无统计学差别。结论血浆MMP-9是一个反映炎症病程的生化指标,可用于预测及诊断早期多器官功能障碍。
Objective To explore the clinical value of plasma MMP-9 in the early diagnosis of MODS. Methods Inpatients were screened according to the diagnostic criteria and randomly selected cases were included in the injury group, the SIRS group and the MODS group, and the healthy subjects were randomly selected as the control group. Plasma MMP9 concentrations were quantified by enzyme-linked immunosorbent assay. Results The levels of MMP-9, neutrophil and APACHEⅢ in injury group, SIRS group and MODS group were higher than those in control group, and were gradually increased. The level of MMP-9 positively correlated with the level of neutrophil and APACHEⅢ score. According to the course of the disease, SIRS was divided into MODS group and non-MODS group, and MODS group was death group and survivor group. Compared with non-MODS group, MMP-9 plasma concentration and APACHEⅢ score in four groups were worse than non-MODS group Group, but there was no significant difference in MMP-9 in survival group between MODS group and MODS group in SIRS group. Conclusion Plasma MMP-9 is a biochemical index reflecting the course of inflammation and can be used to predict and diagnose early multiple organ dysfunction.