| Objective: This study aimed to analyze the level of serum matrix metalloproteinase 9(matrix metalloprote 9 inases,MMP-9)on chronic obstructive pulmonary disease(COPD)patients with smoking of high-resolution computed tomography(HRCT)and its related factors.Methods: A total of 94 patients with COPD were enrolled in the Department of Respiratory Medicine,China National Petroleum Corporation Central Hospital from January 2016 to January 2017 as the observation group.Including 56 males and 38 females;the age distribution was 48-87 years old,the average age(71.19 ± 0.894)years old.And the same period of our hospital physical examination center examination of 29 cases as the control group.Patients admitted to the standard:(1)in line with COPD diagnostic criteria that meet the Chinese Medical Association of Respiratory Diseases Chronic Obstructive Pulmonary Disease Group developed the "Guidelines for the diagnosis and treatment of chronic obstructive pulmonary disease(2013revision)" : after inhalation bronchodilator FEV1 / FVC <0.7,as a continuous air flow limit,can be diagnosed as COPD;(2)age ? 40 years;(3)patients and their families informed consent and signed informed consent.The control group inclusion criteria:(1)40 years of age or older;(2)no smoking history;(3)healthy examination and showed normal lung function,the body's function indicators were normal healthy people;(4)subjects were tested;Informed consent and signed informed consent.Exclusion criteria:(1)those who did not meet the inclusion criteria;(2)unwilling to participate in the study.All selected participants to collect information as follows: gender,age,past history,smoking situation.Routine routine examination: blood,erythrocyte sedimentation rate,PCT,CRP,lung function,chest HRCT and soon.The patients were divided into three groups: A,E and M according to the emphysema and bronchial wall thickness;The patients were divided into smoking group and non-smoking group according to the smoking status of the patients.The use of Beijing Dongge Biotechnology Co.,Ltd.to provide MMP-9 kit,serum samples of all subjects in strict accordance with the instructions for MMP-9 determination.Application of SPSS 19.0 software for data analysis.Before the analysis,the data were normalized and the homogeneity of variance was tested.The data of the normal distribution are expressed by x ±s,and the non-normal distribution data is logarithmically converted.The statistical data of the normal distribution between groups were analyzed by ANOVA.Multiple comparisons were performed by LSD test.The nonuniform distribution data were analyzed by rank sum test(Kruskal-Wallis H test).Single factor correlation analysis was performed using Spearman correlation analysis and plotted plotted one by one.Comparison of count data using ?2 test,multi-factor correlation analysis using multiple stepwise linear regression analysis.P<0.05 for the difference was statistically significant.Results:1 The expression of MMP-9 in the observation group was significantly higher than that in the healthy control group(27.23 ±10.213ng/ml)(P<0.05).The difference between the two groups was(128.56±9.074ng/ml)Statistical significance.2 The expression of MMP-9 was(128.11±10.23ng/ml)in 56 cases of type A,E and M in the observation group,and the expression level of MMP-9 was 10(128.06±9.07ng/ml).There was no significant difference between the two groups(P>0.05).There was no significant difference between the two groups(P <0.05).3 In COPD smoking and non-smoking patients and their A,E,M three types of MMP-9 comparison3.1 Smoking group and non-smoking group compared with MMP-9 The expression of MMP-9 in the smoking group was(130.49±9.01 ng/ml).Theexpression of MMP-9 in the non-smoking group was(123.23±6.96 ng/ml),and the difference was statistically significant.3.2 Comparison of MMP-9 in smoking group A,E and M MMP-9(128.31±7.77ng/ml)was significantly lower than that of E and A(133.69±10.17ng/ml)(135.62±9.94ng/ml)in the smoking group,the difference was statistically significant(t=2.05,2.65,P<0.05).There was no significant difference in MMP-9 phenotype between smokers(P>0.05).4 Analysis of CT Classification in Patients with Smoking4.1 Comparison of LAA scores between smoking group and non-smoking group There was a significant difference between the LAA score(9.38±4.62)and the non-smoking patients(6.32±4.45)in the smoking group(t=2.86,P<0.01).4.2 Comparison of LAA scores in smoking group and non-smoking group A,E and M The difference was statistically significant between the smoking group and the non-smoking patients(P<0.01).But there was no significant difference between the M-type and the E-type in the LAA score(P>0.05).4.3 Comparison of T/PA in smoking group and non-smoking group A,E and M There was no significant difference between the smoking group and the non-smoking group(t=1.51,P>0.05),but there was significant difference between the smoking group and the non-smoking group(t=2.42,t=2.82,P<0.05).5 Comparison of Inflammatory Index and Lung Function5.1 Comparison neutrophil percentage and lymphocyte percentage between smoking group and non-smoking group Smoking group peripheral blood neutrophil percentage(76.78±10.80%)and lymphocyte percentage(15.73±9.18%)and non smoking group neutrophil percentage(67.41±12.65%)and lymphocyte percentage(22.51±12.08%)compared to the difference was statistically significant(t=3.55,t= 2.90,P<0.01).5.2 Comparison of FEV1% between smoking group and non-smoking group In the observation group,the non-smoking group FEV1% was better than the smoking group,the difference was statistically significant(t=2.11,P<0.05).6 Effects of smoking and COPD comorbidity on MMP-96.1 The number of comorbidities The number of comorbidities in more than3 patients were significantly different between smokers and non-smokers on MMP-9(?2=12.08,P<0.01).6.2 Comorbidity was associated with cardiovascular disease in MMP-9Smokers and nonsmokers,there was a statistically significant difference in MMP-9 between patients with and without cardiovascular disease(P<0.05).Conclusions:1 the expression level of serum COPD in the observation group was significantly higher than that in the control group,indicating that MMP-9 is involved in the pathogenesis of MMP-9 in patients with COPD.2 COPD patients,A,E,M expression of different phenotypes of no significant difference,suggesting that MMP-9 is not the only involved in airway wall thickening and emphysema of metalloproteinases.The expression level of MMP-9 in smokers was higher,which indicated that smoking was the most important factor leading to airway inflammation,airway structure and airway remodeling.The decrease of FEV1% in smoking group was more obvious,which indicated that smoking caused more obvious airflow limitation.3 the percentage of neutrophils in peripheral blood of smokers was higher than that of non-smokers,which indicated that smoking was more obvious.4 smoking causes multiple comorbidities in patients with COPD,especially cardiovascular disease. |
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