腹主动脉瘤患者血浆MMP-9含量测定及其意义

Measurement and significance of plasma level of matrix metalloproteinase-9 in abdominal aortic aneurysms

目的 初步探讨基质金属蛋白酶 9(MMP 9)在腹主动脉瘤 (AAAs)致病机制中的作用。方法 采集 2 0 0 2年 2月至2 0 0 2年 8月德国科隆大学医院血管外科中心收治的 35例AAAs患者治疗前后的血液标本 ,利用酶联免疫分析方法(ELISA)逐一测定血浆MMP 9含量 ,并检测同期住院的 10例动脉硬化闭塞性疾病 (AODs)患者的血浆MMP 9含量作为对照。结果 AAAs患者术前血浆MMP 9含量明显高于AODs患者 [(90 .2 5± 9.12 ) μg·L-1vs.(2 3.5 8± 7.33) μg·L-1,P <0 .0 5 ],治疗后 1月血浆MMP 9含量明显下降 ,与术前相比有显著差异 [(2 8.5 5± 8.35 ) μg·L-1vs.(90 .2 5± 9.12 ) μg·L-1,P <0 .0 5 ],而与AODs患者无显著差别 [(2 8.5 5± 8.35 ) μg·L-1vs.(2 3.5 8± 7.33) μg·L-1,P >0 .0 5 ]。AODs患者治疗前后的MMP 9血浆水平无明显变化 [(2 3.5 8± 7.33) μg·L-1vs.(2 5 .2 8± 5 .78) μg·L-1,P >0 .0 5 ]。结论 腹主动脉瘤患者血浆MMP 9水平的明显升高 ,提示MMP 9与腹主动脉瘤的发病有密切关系 ;动态监测MMP 9含量变化有望成为腹主动脉瘤的早期诊断及术后疗效判断的重要手段。

Objective To investigate the ch an ges of matrix metalloproteinase-9 (MMP-9) plasma level in the patients with ab dominal aortic aneurysms (AAAs) before and after the treatment, and evaluate the importance of MMPs in the pathogenesis of AAAs. Methods Blood samples of 35 patients with AAAs and 10 patie nts with arterial occlusive diseases (AODs), who were admitted to the Vascular S urgery Center of Colonge University Hospital from Feburary to August 2002, were collected before and one month after open surgical repair or interventional endo vascular exclusion. The plasma concentrations of MMP-9 of all the collected sam ples were measured by enzyme-linked immunosorbent assay (ELISA), and compared b etween the two groups at different time points. Results The mean plasma concentration of MMP-9 of AAAs was significantly higher than that of AODs [(90.25± 9.12) vs. (23.58±7.33 )μg·L -1, P<0.05] before treatment, and no apparent difference w as shown in the patients with AODs [(23.58±7.33) vs. (25.28±5.78)μg ·L -1, P>0.05] before and after the surgical bypass operation. Howeve r, in the patients with AAAs the plasma concentration of MMP-9 was apparently d ecreased one month after the open surgical repair or endovascular exclusion comp ared with before [(28.55±8.35)vs. (90.25± 9.12)μg·L -1, P <0.05]. No significant difference was found between the two groups after bein g successfully treated [(28.55±8.35) vs. (25.28±5.78)μg·L -1, P>0.05]. Conclusion The apparent elevation of plasma concentration o f MMP-9 in the AAAs implies that MMP-9 may be closely related to the formation and development of AAAs. Meanwhile, to investigate the changes of plasma MMP-9 level of AAAs can provide an important way to facilitate the earlier diagnosis and long-term follow-up for AAAs.