基质金属蛋白酶-9在后交通动脉瘤瘤周蛛网膜中的表达及临床意义

Expression of matrix metalloproteinase-9 in the arachnoid membrane around posterior communicating artery aneurysms

目的初步探讨基质金属蛋白-9（MMP-9）在后交通动脉瘤瘤周蛛网膜中的表达及意义。方法选取南方医科大学南方医院2010年11月~2011年11月手术切除的颅内动脉瘤标本12例作为颅内动脉瘤组,并选取同期行海绵状血管瘤手术或颞叶癫痫手术患者后交通动脉起始部附近蛛网膜组织6例作为对照组。标本行常规HE染色,并采用Envision法行免疫组化染色,比较组间MMP-9的阳性表达情况。结果 HE染色提示动脉瘤瘤周的蛛网膜存在一定的组织破坏,表现为蛛网膜结构松散,与血管壁之间的连接程度下降,局部存在脱离现象。动脉瘤组瘤周蛛网膜中MMP-9阳性表达均高于照组,具有统计学意义（P〈0.05）。动脉瘤组内蛛网膜中MMP-9的阳性表达强度较血管壁弱,具有统计学意义（P〈0.05）;动脉瘤组内不同年龄、Hunt-Hess分级的MMP-9表达情况无显著性差异。结论动脉瘤瘤周蛛网膜中MMP-9表达明显增加预示着细胞外基质的溶解,破坏蛛网膜对血管壁的保护作用,可能与后交通动脉瘤的形成有重要关系。

Objective To investigate the expression of matrix metalloproteinase-9(MMP-9) in the arachnoid membrane around posterior communicating artery aneurysms.Methods Twelve patients with posterior communicating artery aneurysms undergoing surgical intervention in our hospital between November,2010 and November,2011 were enrolled as the case group along with 6 concurrent patients with severely head trauma or epilepsy as controls.The expression of MMP-9 in the aneurysmal walls and the arachnoid membrane was examined in immunohistochemistry,and HE staining and Sirus red staining were performed to examine the pathological changes.Results The perianeurysmal arachnoid membrane showed tissue destruction and disruption of the connections between the membrane and the artery wall with local detachment.Compared with that in the control group,the level of MMP-9 in the arachnoid membrane was significantly higher in the case group(P<0.05),but significantly lower than that in the aneurysm wall within the same sample(P<0.05).No differences were found in the levels of MMP-9 in the aneurysm patients with different ages or Hunt-Hess scale scores.Conclusion MMP-9 is closely related with the formation of posterior communicating artery aneurysms by causing degradation of extracellular matrix of the vascular wall and the arachnoid membrane.