骨唾液蛋白和基质金属蛋白酶-9在风湿性心脏病钙化瓣膜中的表达及意义

The expression and significance of bone sialoprotein and matrix metalloproteinase-9 in calcified valves of patients with rheumatic heart disease

目的观察骨唾液蛋白（BSP）和基质金属蛋白酶．9（MMP-9）在风湿性心脏病（风心病）钙化瓣膜中的表达情况。方法将手术切除的二尖瓣瓣膜（共150枚）按病史分为风心病组（120枚）和非风心病组（30枚），采用sP法进行免疫组织化学染色，观察并比较两组BSP和MMP-9的：羡达情况。结果风心病组BSP和MMP-9阳性表达率分别为91．7％（11-120）和90．8％（109／120），显著高于非风心病组的23．3％（7／30）和20．0％（6／30），差异均有统计学意义（P〈0．01）。结论风心病瓣膜BSP和MMP-9高表达，风心病瓣膜的钙化与MMP-9所引起的细胞外基质降解和重塑以及BSP所诱导的成骨样骨形成密切相关。

Objective To observe the expression of bone sialoprotein （BSP） and matrix metalloproteinase-9 （MMP-9） in calcified valves of patients with rheumatic heart disease. Methods A total of 150 mitral valves which were resected by surgery were divided into rheumatic group （ 120 valves ） and non- rheumatic group （30 valves）. Immunohistochemical staining was taken by SP method and the expressions of BSP and MMP-9 in two groups were observed and compared. Results The positive expressions of BSP aJld MMP-9 in rheumatic group were 91.7%（110/120） and 90.8%（109/120） ,respectively,which were significantly higher than those in non-rheumatic group [23.3%（7/30） and 20.0%（6/30） ]（P〈 0.01 ）. Conclusions The expressions of both BSP and MMP-9 are higher in the valves of patients with rheumatic heart disease. The calcification of rheumatic mitral valves is closely related with the degradation and remodeling of extracellular matrix caused by MMP-9, and osteoblast-hke bone formation induced by BSP.