基质金属蛋白酶类在颅内动脉瘤中的表达

Expression of the matrix metalloproteinase-2 and 9 in intracranial aneurysms

目的检测基质金属蛋白酶类(MMPs)中MMP-2、MMP-9在颅内动脉瘤中的表达情况。方法取经DSA证实为颅内动脉瘤,并经显微神经外科手术夹闭动脉瘤的17例患者的17个动脉瘤的瘤壁组织为研究标本(动脉瘤组)。17个动脉瘤中,小动脉瘤10个,大动脉瘤7个;Hunt-HessⅠ～Ⅱ级的患者为11例,≥Ⅲ级的患者为6例。对照组为同期经CT及MRI证实为非血管性疾病的外伤患者,共15例,取其颞浅动脉组织为对照标本。经HE染色及免疫组化染色,检测动脉瘤的瘤壁组织和正常血管壁的组织结构变化及其中MMP-2、MMP-9的表达情况,计算阳性指数(PI)。结果①对照组的动脉壁各层MMP-2、MMP-9的阳性表达较低。动脉瘤组瘤壁组织的内膜、中膜、外膜有MMP-2、MMP-9的阳性表达。②动脉瘤组患者MMP-2、MMP-9的阳性表达率分别为88.2%和82.4%,高于对照组的6.7%和13.3%,差异有统计学意义,P<0.01。③小动脉瘤患者MMP-2和MMP-9的PI值分别为5.1±2.2、5.1±4.2,大动脉瘤患者MMP-2和MMP-9的PI值分别为4.6±2.4、4.1±2.3,差异均无统计学意义,P>0.05。④Hunt-HessⅠ～Ⅱ级患者MMP-2和MMP-9的PI值分别为4.5±1.6、4.2±3.7,高于Ⅲ级患者的MMP-2和MMP-9的PI值(分别为5.7±3.1、5.7±3.1),差异均无统计学意义,P>0.05。⑤经Spearman相关分析,动脉瘤组MMP-2的PI值与MMP-9的PI值呈正相关,r=0.425,P<0.05。结论 MMP-2、MMP-9在动脉瘤的瘤壁组织中表达较高,其高表达可能促进了颅内动脉瘤的形成和破裂。

Objective To detect the expression of matrix metalloproteinase-2 and 9 （MMP-2 and MMP-9） in intraeranial aneurysms . Methods 17 patients were diagnosed as intraeranial aneurysms with DSA and clipped by mierosurgery were enrolled in the study （ aneurysm group）. Each patients had one an- eurysms, 10 were small aneurysms, and 7 were large aneurysms; 11 patients with Hunt-Hess grade Ⅰ to Ⅱ and 6 with Hunt-Hess grade Ⅲ. 15 patients with cerebral trauma but without vascular diseases confirmed by CT and MRI as the control group. HE staining and immunohistoehemical staining were used to detect the expression of MMP-2 and MMP-9 in the aneurysm wall and normal vessel wall tissue. The positive index （PI） was calculated. Results （1）The positive expression of MMP-2 and MMP-9 in each layer of aneu- rysm walls in the control group was low. The intima, media, and adventitia of the aneurysm wall tissue had positive expression of MMP-2 and MMP-9 in the aneurysm group. （2）The positive expression rates of MMP- 2 and MMP-9 in patients of the aneurysm group were 88.2% and 82.4% respectively. They were higher than 6.7% and 13.3% of the control group. The difference was statistically significant （P 〈 0.01 ）. （3）The PI values of MMP-2 and MMP-9 of the small anenrysms were 5.1 ± 2.2 and 5.1 ± 4.2 respectively; the PI values of MMP-2 and MMP-9 of the large aneurysms were 4.6 ± 2.4 and 4.1 ±2.3 respectively. The differences were not statistically significant （ P 〉 0.05 ）. （4）The PI values of MMP-2 and MMP-9 in pa- tients with Hunt-Hess Ⅰ or Ⅱ were 4.5 ± 1.6 and 4.2± 3.7 respectively ; the PI values of MMP-2 and MMP-9 in patients with Hunt-Hess ≥ Ⅲ were 5.7 ± 3.1 and 5.7± 3.1 respectively. The differences were not statistically significant （ P 〉 0.05 ）. Spearman correlation analysis showed that the PI values of MMP-2 and MMP-9 in the aneurysm group were positively correlated （ r = 0. 425 ; P 〈 0.05 ）. Conclusion The expression of MMP-2 and MMP-9 is higher in the aneurysm wall tissue, and it may be involved in the for- mation and rupture of intracranial aneurysms.not statistically significant （ P 〉 0.05 ）. Spearman correlation analysis showed that the PI values of MMP-2 and MMP-9 in the aneurysm group were positively correlated （ r = 0. 425 ; P 〈 0.05 ）. Conclusion The expression of MMP-2 and MMP-9 is higher in the aneurysm wall tissue, and it may be involved in the for- mation and rupture of intracranial aneurysms.