摘要
目的 研究基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)及组织基质金属蛋白酶抑制剂-1(tissue inhibitors of metalloproteinasel,TIMP-1)在脑动静脉畸形(cerebuilar arteriovenous malformations,CAVM)患者组织中的表达及其与出血的关系。
方法 选取我院2007年5月至2008年9月间收治的48例CAVM患者。按有无出血症状分为出血组和非出血组,并选取24例原发癫痫患者为正常对照组。分别对其病史、临床症状、影像学表现等进行研究。对患者术中脑组织标本的MMP-9、TIMP-1含量以免疫组化方法进行研究。
结果 MMP-9、TIMP-1均表达在胞浆中。MMP-9在正常对照组仅见微量表达;而在CAVM患者组织标本中可见表达明显升高。TIMP-1在CAVM患者组织中表达水平显著高于对照组,与MMP-9表达平行,出血组组与非出血组之间MMP-9、TIMP-1均无统计学差异,但两者之比(MMP-9/TIMP-1)有统计学差异。
结论 ①MMP-9可能是导致CAVM血管壁结构不稳定、生长和过度扩张的重要因素,其水平升高可能是TIMP-1表达的促进因素之一;②MMP-9可能对于CAVM患者的出血具有促进作用,TIMP-1有着抑制MMP-9活性的重要作用,是防止CAVM出血的“保护因子”。MMP-9和TIMP-1比例失衡,造成MMP-9相对“过盛”,可能是引起脑动静脉畸形出血的重要机制。
Objective To examine the expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitors of metalloproteinasel(TIMP-1) in cerebullar arteriovenous malformations (CAVM) and their relationship with hemorrhagic history in CAVM.
Methods 48 patients who suffered with CAVM were studied, including 24 patients with hemorrhagic history (CAVM H group) and 24 patients without hemorrhagic history (CAVM N group). 24 patients suffered with essential epilepsy were control group (CG). All of the patients admitted during May 2007-September 2008 and were given operation. We studied their history, clinical symptom and radiologic manifestation, examined the expression of MMP-9, TIMP-1 in patients brain tissue by immunohistochemistry.
Results Compared with control samples, CAVM samples had higher levels of MMP-9, TIMP- 1(P〈0.01).There was no significant difference in levels of MMP-9, TIMP-1(P〉0.05) between CAVM H Group and CAVM N Group, But, Compared with CAVM N Group, CAVM H Group had higher levels of MMP-9/TIMP-1(P〈0.05).
Conclusion ①Maybe MMP-9 is a essential factor lead to structural instability, growth and abnormal extension of vessels in CAVMs. MMP-9 is one of the factors to promote expression of TIMP-1. ②MMP-9 can lead hemorrhage in CAVMs, as the endogenous specific inhibitor of MMP-9, TIMP-1 is a protective factor to prevent hemorrhage in CAVMs.Perhaps disbalance of MMP-9 and TIMP-1, MMP-9 is higher relatively is a important reason of hemorrhage in CAVMs.
出处
《中国卒中杂志》
2009年第7期576-580,共5页
Chinese Journal of Stroke