Abstract: To observe the extracellular matrix remodeling on children with airway foreign body aspiration (FBA) through detecting the expression of matrix metalloproteinase-9 (MMP-9),tissue inhibitor of matrix metalloproteinase-1 (TIMP-1),and hydroxyproline (HYP) in bronchoalveolar lavage fluid (BALF). Methods12 controls and 46 children with FBA removed via fiberoptic bronchoscopy from 2002~2003 were studied in our unit.Patients were divided into 3 subgroups according to the duration of FBA (subgroup A:<7 days; subgroup B:7~30 days; subgroup C:>30 days).Cell count,levels of MMP-9,TIMP-1 in BALF cells and HYP of BALF was measured. ResultsThe total number of cells and differential cells recovered in BALF did not differ significantly between patients and controls (P=0.431).The positive rate of MMP-9 in controls and subgroups of patients were 33.3%,62.5%,80.0%,and 93.3% with a significant difference (P=0.006).The positive rate of TIMP-1 was 16.3%,50.0%,80.0%,and 93.3% with a significant difference (P<0.001).The differences of HYP in controls and different patients are significant as well (P<0.001).There were positive correlations between the MMP-9,TIMP-1,HYP levels in patients and duration of FB retention (P<0.05).The levels of MMP-9 and TIMP-1 were also associated with percent of mast cell (P=0.009,P=0.005).The differences of MMP-9 and TIMP-1 before and after FB removed were not significant (P=0.131,P=0.522),while the HYP levels decreased significantly than that before FB removed (P=0.001). ConclusionMMP-9,TIMP-1 and HYP are significantly elevated in children with FBA and are related to the extracellular matrix remodeling.These changes are irreversible in short time

Key words: Hydroxyproline, Tissue inhibitor of matrix metalloproteinase-1 , Bronchoalveolar lavage fluid, Matrix metalloproteinase-9

摘要： 目的以肺泡灌洗液(BALF)中羟脯氨酸(HYP)、基质金属蛋白酶9(MMP-9)及其抑制物(TIMP-1)为观察指标，了解呼吸道异物吸入对气道损害、重建的影响。 方法对2002年6月至2003年3月在浙江大学儿童医院住院的46例呼吸道异物患儿，按异物滞留体内时间分为3组(A组：<7d，B组：~30d，C组：>30d)，对3组患儿的BALF进行细胞学分析，并对其中的HYP、MMP-9细胞阳性率和TIMP-1质量浓度进行测定。对照组为12例有异物吸入可疑病史，但最后排除的儿童。 结果对照组与患儿组间细胞学计数差异无显著性(P>0.05)，但肥大细胞仅在患儿BALF中发现。对照组及各组患儿的MMP-9细胞阳性率分别为33.3%、62.5%、80.0%和93.3%，TIMP-1细胞阳性率分别为16.3%、50.0%、80.0%和93.3%，总体差异均有显著性意义(P=0.006和P<0.001)；各组间HYP差异有显著性意义(P<0.001)。 结论气道异物促进MMP-9、TIMP-1及HYP的表达和分泌，提示气道异物可导致支气管肺组织破坏和重建，其程度与异物滞留时间有关。

关键词: 异物, 支气管肺泡灌洗液, 基质金属蛋白酶9, 羟脯氨酸, 基质金属蛋白酶抑制剂1