关键词: 常染色体显性遗传性多囊肾, 基质金属蛋白酶1, 组织金属蛋白酶抑制因子1, 腹腔镜去顶减压术, 预后

Abstract: Ｏｂｊｅｃｔｉｖｅ：To investigate the expression of matrix metalloproteinase1 (MMP1) and tissue inhibitor of metalloproteinase1 (TIMP1) in peripheral blood of patients with autosomal dominant polycystic kidney disease (ADPKD) and their relationship with prognosis.
Ｍｅｔｈｏｄｏｌｏｇｙ：The clinical data of 69 patients with ADPKD who underwent laparoscopic deparing decompression in our hospital and 40 healthy subjects from January 2017 to December 2020 were reviewed, The expression of MMP1 and TIMP1 mRNA and MMP1／TIMP1 mRNA in patients with different renal function (compensated and decompensated) and different renal volume (≤750 cm3 and> 750 cm3) before operation was compared. Taking the median of MMP1／TIMP1 mRNA as the boundary of expression, the level of MMP1／TIMP1 mRNA on the prognosis of surgery were compared.
Ｒｅｓｕｌｔｓ：The expressions of MMP1 and TIMP1 mRNA in peripheral blood of ADPKD group were higher than those of control group, and MMP1／TIMP1 mRNA were lower than that of control group (P<005). MMP1 mRNA and MMP1／TIMP1 mRNA in renal decompensated ADPKD patients were lower than those in renal decompensated patients, and TIMP1 mRNA was higher than those in renal decompensated patients (P<005). MMP1 mRNA in patients with renal volume>750 cm3, MMP1／TIMP1 mRNA lower than those with renal volume≤750 cm3, and TIMP1 mRNA higher than those with renal volume≤750 cm3 (P<005). KaplanMeier analysis showed that patients with different MMP1／TIMP1 mRNA ratios had statistically significant differences in cumulative postoperative pain relief survival curve, hypertension control survival curve and renal function maintenance survival curve (all P<0001). Multivariate COX analysis showed that, the low ratio of MMP1／TIMP1 mRNA≤263 affects the prognosis of ADPKD surgery, pain relief (HR=1667,95％CI 1021～2704), blood pressure control time (HR=1530,95％CI 1032～2536) and renal function maintenance time (HR=3102,95％CI 1214～8771)(P<005).
Ｃｏｎｃｌｕｓｉｏｎ：The expression of MMP1／TIMP1 in peripheral blood of ADPKD patients is unbalanced, and the patients with high ratio of MMP1／TIMP1 mRNA have better prognosis of pain relief, hypertension control and longer maintenance of renal function after top decompression.

Key words: autosomal dominant polycystic kidney disease, matrix metalloproteinase 1, tissue Metalloproteinase Inhibitor 1, laparoscopic decapitation decompression,, prognosis