Department of Anaesthesiology and Intensive Care, CHC Bezanijska Kosa, 11000 Belgrade, Serbia.
Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia.
Dis Markers. 2018 May 16;2018:5064684. doi: 10.1155/2018/5064684. eCollection 2018.
The role of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in sepsis after major abdominal surgery and sepsis-associated organ dysfunction is unexplored.
Fifty-three patients with sepsis after major abdominal surgery were compared to 50 operated and 50 nonoperated controls. MMP-9, TIMP-1, biomarkers of inflammation, kidney and liver injury, coagulation, and metabolic disorders were measured daily during 96 h following diagnosis of sepsis and once in controls. MMP-9/TIMP-1 ratios and disease severity scores were calculated. Use of vasopressors/inotropes, mechanical ventilation, and survival were recorded.
Septic patients had lower MMP-9 and MMP-9/TIMP-1 ratios but higher TIMP-1 levels compared to controls. AUC-ROC for diagnosis of sepsis was 0.940 and 0.854 for TIMP-1 and 0.924 and 0.788 for MMP-9/TIMP-1 ratio (sepsis versus nonoperated and sepsis versus operated controls, resp.). Lower MMP-9 and MMP-9/TIMP-1 ratio and higher TIMP-1 levels were associated with shorter survival. MMP-9, TIMP-1, and MMP-9/TIMP-1 ratio correlated with biomarkers of inflammation, kidney and liver injury, coagulation, metabolic disorders, and disease severity scores. Use of vasopressors/inotropes was associated with higher TIMP-1 levels.
MMP-9, TIMP-1, and MMP-9/TIMP ratio were good diagnostic or prognostic biomarkers of sepsis after major abdominal surgery and were linked to sepsis-associated organ dysfunction.
基质金属蛋白酶-9（MMP-9）和基质金属蛋白酶组织抑制剂-1（TIMP-1）在大型腹部手术后脓毒症及与脓毒症相关的器官功能障碍中的作用尚不清楚。
比较了 53 例大型腹部手术后脓毒症患者与 50 例手术和 50 例非手术对照组。在诊断脓毒症后 96 小时内，每天测量 MMP-9、TIMP-1、炎症标志物、肝肾功能损伤、凝血和代谢紊乱标志物，对照组则仅测量一次。计算 MMP-9/TIMP-1 比值和疾病严重程度评分。记录血管加压素/正性肌力药物的使用、机械通气和存活率。
与对照组相比，脓毒症患者的 MMP-9 和 MMP-9/TIMP-1 比值较低，但 TIMP-1 水平较高。TIMP-1 对脓毒症的诊断 AUC-ROC 为 0.940，MMP-9/TIMP-1 比值为 0.854（脓毒症与非手术对照组相比）；TIMP-1 对脓毒症的诊断 AUC-ROC 为 0.924，MMP-9/TIMP-1 比值为 0.788（脓毒症与手术对照组相比）。较低的 MMP-9 和 MMP-9/TIMP-1 比值以及较高的 TIMP-1 水平与存活率较短有关。MMP-9、TIMP-1 和 MMP-9/TIMP-1 比值与炎症标志物、肝肾功能损伤、凝血、代谢紊乱和疾病严重程度评分相关。血管加压素/正性肌力药物的使用与较高的 TIMP-1 水平相关。
MMP-9、TIMP-1 和 MMP-9/TIMP 比值是大型腹部手术后脓毒症的良好诊断或预后生物标志物，与与脓毒症相关的器官功能障碍有关。
