MMP-2和TIMP-2在成人腹股沟疝患者腹直肌前鞘中的表达及意义

Expression and significance of MMP-2 and TIMP-2 in anterior rectus sheath of inguinal hernia

目的从生物化学角度探讨成人腹股沟疝的发病原因。方法选择2016年2至11月,郑州大学第一附属医院施行腹股沟疝手术者,取材部位均为下腹部腹直肌前鞘,面积5 mm×10 mm。本研究设实验组腹股沟疝患者48例,对照组无疝患者10例。用实时荧光定量PCR(RealTime PCR)技术检测各组腹直肌前鞘中MMP-2 mRNA、TIMP-2 mRNA的表达水平。结果直疝组MMP-2mRNA为3.098±1.289,TIMP-2mRNA为0.641±0.308。2者与对照组比较,差异均有统计学意义(P<0.05)。2者在斜疝组的表达,差异均无统计学意义(P>0.05);吸烟者中MMP-2mRNA为2.710±1.058,TIMP-2mRNA为0.628±0.223,2者与非吸烟者相比,差异均有统计学意义(P<0.05);有家族史者MMP-2mRNA为3.358±1.054,TIMP-2 mRNA为0.507±0.224,2者与无家族史者相比,差异均有统计学意义(P<0.05)。结论成人腹股沟直疝患者腹直肌前鞘中MMP-2 mRNA呈高表达,TIMP-2 mRNA呈低表达,表明2者的作用导致了机体胶原代谢的紊乱,是腹股沟直疝发生的重要因素。与腹股沟斜疝的发生发展无明显关系。吸烟者MMP-2 mRNA表达增高、TIMP-2 mRNA表达降低,表明吸烟是腹股沟疝发生的因素之一。有家族史者MMP-2 mRNA呈高表达、TIMP-2mRNA呈低表达,表明腹股沟疝的发生与遗传因素有关。

Objective To explore the pathogenesis of adult inguinal hernia from the perspective of biochemistry. Methods From February 2016 to November 2016,58 patients from the First Affiliated Hospital of Zhangzhou University were enrolled,and specimens for the anterior rectus sheath（ 5 mm ×10 mm） were obtained. In this study,there were 48 patients with inguinal hernia and 10 patients without hernia in the control group. The expression of MMP-2 mRNA and TIMP-2 mRNA in the anterior fascia of the rectus abdominis were detected by real-time PCR. Results The MMP-2 mRNA was 3. 098 ± 1. 289 and the TIMP-2 mRNA was 0. 641 ± 0. 308 in the direct inguinal hernia group. Compared with the control group,these differences were significant. While in indirect inguinal hernia group,there was no significant difference in the expression of MMP-2mRNA and TIMP-2mRNA. The expression of MMP-2 mRNA in smokers was 2. 710 ± 1. 058 and that of TIMP-2mRNA was 0. 628 ± 0. 223,the difference was statistically significant compared with non-smokers. The MMP-2 mRNA of patients with family history was 3. 358 ±1. 054 and TIMP-2 mRNA was 0. 507 ± 0. 224,which was statistically significant compared with those without family history. Conclusions The MMP-2 mRNA in the abdominal anterior sheath of the direct adult inguinal hernia patients was highly expressed and the expression of TIMP-2 mRNA was low,which indicated that the two factors caused the disorder of collagen metabolism and the important factors of direct inguinal hernia occurrence. However,it has the no significant relationship with the development of indirect inguinal hernia. The expression of MMP-2 mRNA and the expression of TIMP-2 mRNA were decreased in smokers,indicating that smoking was one of the factors in the pathogenesis of inguinal hernia. MMP-2 mRNA was highly expressed in patients with family history and the expression of TIMP-2 mRNA was low,indicating that the occurrence of inguinal hernia was related to genetic factors.