Duda Izabela, Krzych Łukasz, Jędrzejowska-Szypułka Halina, Lewin-Kowalik Joana
Medical University of Silesia School of Medicine in Katowice, Katowice, Poland.
Department of Anesthesiology and Intensive Care, Faculty of Medicine in Katowice, Medical University of Silesia in Katowice Katowice, Poland.
Open Med (Wars). 2020 Mar 4;15:50-56. doi: 10.1515/med-2020-0008. eCollection 2020.
Matrix metalloproteinase 9 (MMP-9) plays an important role in inflammatory and pathological processes by enabling the inflow of leukocytes to the site of infection or tissue damage. MMP-9 and tissue inhibitor of metalloproteinase 1 (TIMP-1) have been described as potential prognostic biomarkers in various clinical settings. The aim of the study was to evaluate the usefulness of plasma levels of MMP-9 and TIMP-1 as well as the MMP-9/ TIMP-1 ratio in predicting the outcome in patients admitted to the intensive care unit (ICU). The study included 56 critically ill patients with multiple organ failure. Plasma levels of MMP-9 and TIMP-1 were determined on hospitalization day 1, 2, 3 and 7. Nineteen (35.7%) patients died. The level of TIMP-1 was statistically significantly higher on day 1 and 7 of hospitalization in non-survivors, as compared to survivors (p=0.01). A statistically significant positive correlation was found between MMP-9 and TIMP-1. The MMP-9/TIMP-1 ratio was comparable in both groups during of observation (0.62 on day 1). The MMP-9/TIMP-1 ratio was positively correlated with the level of lactate and negatively correlated with platelet count. Likewise, TIMP-1 was positively correlated with the level of lactate. The level of MMP-9 was higher in the non-survivor group only on day 7 of observation. In conclusion, although TIMP-1 and MMP-9 concentrations were higher in non-survivors and the MMP-9/TIMP-1 ratio was related to some parameters of critical illness, further research is needed to verify whether they can serve as reliable biomarkers for early prognostication of ICU patients.
基质金属蛋白酶9（MMP - 9）通过促使白细胞流入感染或组织损伤部位，在炎症和病理过程中发挥重要作用。MMP - 9和金属蛋白酶组织抑制剂1（TIMP - 1）在各种临床环境中已被描述为潜在的预后生物标志物。本研究的目的是评估血浆中MMP - 9和TIMP - 1水平以及MMP - 9/TIMP - 1比值在预测重症监护病房（ICU）患者预后方面的效用。该研究纳入了56例患有多器官衰竭的重症患者。在住院第1、2、3和7天测定血浆MMP - 9和TIMP - 1水平。19例（35.7%）患者死亡。与存活者相比，非存活者在住院第1天和第7天的TIMP - 1水平在统计学上显著更高（p = 0.01）。发现MMP - 9和TIMP - 1之间存在统计学上显著的正相关。在观察期间，两组的MMP - 9/TIMP - 1比值相当（第1天为0.62）。MMP - 9/TIMP - 1比值与乳酸水平呈正相关，与血小板计数呈负相关。同样，TIMP - 1与乳酸水平呈正相关。仅在观察第7天，非存活者组的MMP - 9水平更高。总之，尽管非存活者的TIMP - 1和MMP - 9浓度更高，且MMP - 9/TIMP - 1比值与一些危重病参数相关，但仍需要进一步研究以验证它们是否可作为ICU患者早期预后的可靠生物标志物。
