基质金属蛋白酶1与冠状动脉粥样硬化斑块破裂的关系

Matrix metalloproteinase-1 and coronary atheroslerotic plaque rupture

目的 探讨冠状动脉粥样硬化斑块破裂与基质金属蛋白酶 1(MMP 1)的关系 ,以及不稳定斑块中MMP 1的来源。方法 收集 2 0例死于急性心肌梗死、10例有不稳定心绞痛史 ,以及 12例有稳定心绞痛史的尸体解剖病例共 42例 ,从冠状动脉各分支取材 ,常规病理检查 ,部分节段行MMP 1、平滑肌肌动蛋白、CD6 8、CD45RO和CD2 0染色。结果 在急性心肌梗死及不稳定心绞痛病例中 ,均见有斑块破裂伴血栓形成 ,而在稳定心绞痛病例中 ,除 1例有斑块破裂外 ,其余均为稳定斑块 ;免疫组织化学染色显示破裂的斑块中MMP 1的表达明显高于未破裂的斑块 (t=- 8.0 7,P <0 0 5 ) ;CD6 8和MMP 1二者间的表达呈明显的正相关关系 (r=0 .75 ,P <0 .0 5 )。结论 冠状动脉粥样硬化斑块内MMP 1分泌增多与斑块破裂有密切关系 ;斑块内巨噬细胞具有分泌MMP 1的活性。

Objective To investigate the relationhsyhip between matrix metalloproteinase-1 (MMP-1) and coronary atherosclerotic plaque rupture, and the cellular source of MMP-1 within the plaques. Methods 42 cases, among which 20 died of acute myocardial infarction, 10 with unstable angina history and 12 with stable angina history but died of other diseases, were selected. All the branch of coronary arteries were examined , parts of the segments were selected for immunohistochemical staining, 5 markers against α-smooth muscle actin、CD20、CD45RO、CD68 and MMP-1 were performed. Results Plaque rupture and thrombosis were found in almost all the cases of acute myocardial infarction and unstable angina. But in the cases of stable angina, the majority of the plaques were stable ones. The expression of MMP-1 in the ruptured plaques were stronger than the unruptured ones ( t =-8.07, P <0.05); Positive relationship was also noted between the expression of CD68 and MMP-1( r =0 75, P <0.05). Conclusion Macrophages are capable of degrading extracellular matrix by secreting MMP-1; Enhanced secretion of MMP-1 within the coronary atherosclerotic plaques has significant relationship with plaque rupture.