Abstract
Objective:To study the expressions of TIMP-1 and MMP-9 in patients with chronic obstructive pulmonary disease (COPD) complicated with spontaneous pneumothorax, and their correlations with treatment outcomes.Methods:A total of 80 COPD patients complicated with spontaneous pneumothorax treated in our hospital from December 2015 to December 2017. The serum expressions of TIMP-1 and MMP-9 in 80 COPD patients complicated with spontaneous pneumothorax (COPD group) and 52 healthy volunteers (control group) were detected by ELISA. The correlations of TIMP-1 and MMP-9 expressions with arterial blood gas parameters as well as scores of MRC breathlessness scale and St. George’s Respiratory Questionnaire (SGRQ) were analyzed.Results:The serum expressions of TIMP-1 and MMP-9 of COPD group were significantly higher than those of control group (P<0.05), but the two groups had similar MMP-9/TIMP-1 ratios (P>0.05). For COPD group, TIMP-1 expression, MMP-9 expression, MMP-9/TIMP-1, Sa(O2) and p(O2) were not correlated (P>0.05). TIMP-1 expression was significantly positively correlated with MRC scale and SGRQ scores (P<0.05). Sa(O2), p(O2) and MRC scale score of low MMP-9 expression, low TIMP-1 expression and low MMP-9/TIMP-1 group were significantly improved compared with those of high MMP-9 expression, high TIMP-1 expression and high MMP-9/TIMP-1 group (P<0.05). MMP-9 expression, TIMP-1 expression or MMP-9/TIMP-1 was not correlated with improvement of SGRQ score. Pulmonary function improvement (Sa(O2) improvement rate ≥5% and/or p(O2) improvement rate ≥10%) was correlated with serum MMP-9 expression, baseline Sa(O2) and p(O2).Conclusion:Increase of serum TIMP-1 and MMP-9 expressions in COPD patients was correlated with symptoms and scores of quality of life, and the expressions were also correlated with short-term treatment reactivity.
Highlights
Chronic obstructive pulmonary disease (COPD) is a common clinical disease typified by airflow limitation that is incompletely reversible and evolves progressively, being closely related with abnormal inflammatory responses of the lung.[1]Pak J Med Sci January - February 2020 Vol 36 No 2 www.pjms.org.pk 192Due to high morbidity rate, disabling rate and mortality rate as well as long disease course, COPD has attracted widespread attention recently.[2,3,4] On the other hand, pneumothorax may occur owing to repeated pulmonary infection and chronic pulmonary fibrosis that damage alveolar structures and lead to their rupture at moderate mechanical pressure
Tissue inhibitors of metalloproteinases (TIMPs)-1 expression was significantly positively correlated with MRC scale and St. George’s Respiratory Questionnaire (SGRQ) scores (r = 0.376 and 0.368 respectively, P
MRC scale score and SGRQ score of COPD group: Sa(O2), p(O2), MRC scale score and SGRQ score of the COPD group were significantly improved after treatment compared with those before treatment (P
Summary
Chronic obstructive pulmonary disease (COPD) is a common clinical disease typified by airflow limitation that is incompletely reversible and evolves progressively, being closely related with abnormal inflammatory responses of the lung.[1]. Due to high morbidity rate, disabling rate and mortality rate as well as long disease course, COPD has attracted widespread attention recently.[2,3,4] On the other hand, pneumothorax may occur owing to repeated pulmonary infection and chronic pulmonary fibrosis that damage alveolar structures and lead to their rupture at moderate mechanical pressure. As a common pleural disease, spontaneous pneumothorax occurs even without traumas or anthropogenic factors, during which lung tissue and visceral pleura spontaneously rupture owing to lung diseases or lung bullae and small emphysematous lesions near the lung surface rupture. The air in the lung and bronchus enters the pleural cavity, which affects cardiopulmonary functions, mostly in the case of COPD. When complicated with spontaneous pneumothorax, COPD further jeopardizes pulmonary function, endangering patient health by inducing severe ischemia as well as cardiopulmonary function failure
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