基质金属蛋白酶-9和纤溶酶原激活物抑制物-1在动静脉内瘘血管内皮中的表达

Expression of matrix metalloproteinase-9 and plasminogen activator inhibitor-1 in vascular endothelial of hemodialysis arteriovenous fistula

目的:探讨基质金属蛋白酶-9(MMP-9)及纤溶酶原激活物抑制物-1(PAI-1)在动静脉内瘘血管内皮中的表达及其对动静脉内瘘功能的影响。方法:纳入20例血液透析患者的失功内瘘及16例新建内瘘,用手术剪切的方法采集血管标本。通过免疫组织化学技术,在蛋白质水平检测36例动静脉内瘘血管内皮细胞中的MMP-9和PAI-1的变化。结果:MMP-9在正常动静脉内瘘血管内皮细胞中微量表达;在失功动静脉内瘘血管内皮细胞中,MMP-9阳性表达明显增多(1.43%vs23.32%,P<0.01)。PAI-1在正常动静脉内瘘血管内皮细胞中微量表达,在失功动静脉内瘘血管内皮细胞中有少量表达(2.28%vs4.62%,P>0.05)。结论:MMP-9在闭塞动静脉内瘘血管内皮细胞中表达明显增多。PAI-1在失功动静脉内瘘血管内皮细胞中表达无明显增多。MMP-9的异常表达可能是影响血液透析患者动静脉内瘘功能的重要因素之一。

Objective To observe the expressions of matrix metalloproteinase-9 （MMP-9） and plasminogen activator inhibitor-1 （PAI-1） in the vascular endothelial of hemodialysis arteriovenous fistula. Methods Arteriovenous fistular vascular segments were collected by shearing from total 36 paitents （the 20 paitents whose fistula had been disfunction or embolized and other 16 paitents whose fistula had been operated for the first time） The protein expression of MMP-9 and PAl-1 were detected by immunohistochemistry assays in arteriovenous fistular vascular segments. Results MMP-9 was expressed at a low level in vascular endothelial cells from paitents whose fistula been operated newly, and increased significantly in vascular endothelial cells from paitents whose fistula been disfunction or embolized （P〈 0.01 ）. PAl-1 was only slightly expressed in vascular endothelial cells from paitents whose fistula had been operated newly and whose fistula had been disfunction or embolized （P 〉 0.05）. Conclusion The abnormal expression of MMP-9 may contribute to the progress of hemodialysis arteriovenous fistular function.