糖尿病患者动脉粥样硬化斑块内基质金属蛋白酶2和9与斑块稳定的关系

Matrix Metalloproteinase-2 and 9 in Atherosclerotic Plaques of Diabetic Patients and Their Relationship with Plaque Stabilization

目的 比较糖尿病患者与非糖尿病组患者动脉粥样硬化斑块内基质金属蛋白酶 2和基质金属蛋白酶 9表达的差异 ,初步探索基质金属蛋白酶 2和基质金属蛋白酶 9与糖尿病动脉粥样硬化斑块稳定的关系。方法 从2 3例糖尿病足截肢和 17例尸检下肢动脉标本中选取晚期动脉粥样硬化病变的组织块共 12 6块 ,分为糖尿病组 (74块 )和非糖尿病组 (5 2块 ) ,从中随机选取各 4 0个组织块 ,运用免疫组织化学染色法检测基质金属蛋白酶 2和 9在两组粥样硬化斑块中的表达。结果 糖尿病组抗基质金属蛋白酶 2、抗基质金属蛋白酶 9免疫沉积物主要集中在斑块核心周围 ,特别是在斑块的肩部和纤维帽。糖尿病组动脉斑块内抗基质金属蛋白酶 2免疫沉积物表达显著高于非糖尿病组 (免疫沉淀物积分光密度值分别为 6 90 14± 14 4 5 9和 5 70 0 4± 16 171,阳性面积百分比分别为 13.0 %± 2 .7%和 11.1%± 3.3% ) ;糖尿病组斑块内基质金属蛋白酶 9表达也显著高于非糖尿病组 (免疫沉淀物积分光密度值分别为 10 2 4 85± 2 0 4 31和 75 2 80± 1310 6 ,阳性面积百分比分别为 18.4 %± 3.6 %和 13.7%± 2 .3% )。结论 基质金属蛋白酶 2和 9在糖尿病组动脉粥样硬化斑块中的表达显著高于非糖尿病组。基质金属蛋白酶 2和

Aim To compare the expression of matrix metalloproteinase-2(MMP-2)and MMP-9 in atherosclerotic plaques of diabetic and non-diabetic patients and to investigate the potential role of MMP-2 and MMP-9 expression in unstabilizing plaques of diabetic patients. Methods Specimens of arteries were obtained from 23 diabetic patients and from 17 autopsy cases with acute coronary syndromes. 126 tissue blocks of late-stage lesions were classified into diabetic group (n=74)and non-diabetic group (n=52). Forty blocks were selected randomly from each group and serial sections were stained immunohistochemically with anti-human MMP-2 and MMP-9 monoclonal antibody. Microscope Image Analyzer was used for relatively quantitative analysis. Results In the diabetic arteries, intense staining was shown around the plaque core, especially in the plaque shoulder and thinned fibrous cap. MMP-2 integrated optical density(IOD) of diabetic group (69 014±14 459) was strikingly higher than that of the non-diabetic group (57 004±16 171). Threshold area of MMP-2 was significantly elevated (P<0.05) in samples from diabetic group (13.0%±2.7%) compared with samples from non-diabetic group with atherosclerosis (11.1%± 3.3% ). IOD of MMP-9 was also significantly higher (P<0.01) in diabetic group (102 485±20 431) than in the non-diabetic group (75 280±13 106). Conclusion The expression of MMP-2 and MMP-9 in atherosclerotic plaques of diabetic group is significantly higher than that of non-diabetic group. MMP-2 and MMP-9 accumulation, which play an important role in unstabilizing plaques, may promote atherosclerotic plaque disruption in diabetic patients.