高压性静脉管壁中膜形态学及细胞外基质代谢的变化

Changes in the morphology and extracellular matrix metabolism of the middle membrane in the wall of high pressure vein

目的观察曲张静脉管壁中膜形态学变化及基质金属蛋白酶MMP-2,MMP-9的表达水平,探讨静脉管壁重塑与基质金属蛋白酶2(MMP-2),基质金属蛋白酶9(MMP-9)表达的关系。方法收集曲张大隐静脉和门静脉高压性脾静脉管壁标本24例,选取正常大隐静脉和脾静脉12例为对照组,制作切片在光镜下观察;采用免疫组化染色法检测MMP-2,MMP-9水平。结果 Masson染色曲张静脉管壁中膜增厚,大隐静脉肌层和纤维结缔组织增生不均匀;高压性脾静脉肌层和纤维结缔组织增生较均匀。曲张组MMP-2,MMP-9阳性率分别为85.4%,90.2%;正常组分别为35.6%,60.8%,两组比较差异有显著性(P<0.01)。结论高压性脾静脉、曲张大隐静脉管壁中膜形态学变化及MMP-2,MMP-9表达升高,其阳性表达程度与病理静脉管壁结构和压力改变有相关性。

Objective To observe the morphological changes of membrane and the expression of matrix metalloproteinases MMP-2 and MMP-9 in varicose vein wall,and explore the relationship between venous wall remodeling and the expression of MMP-2 and MMP-9.Methods Twenty-four specimens of varicose veins and portal vein hypertensive splenic vein wall were collected.The control group was normal saphenous vein and splenic vein in 12 cases.The sections were observed under light microscope.MMP-2 was detected by immunohistochemical staining,MMP-9.Results Masson-stained medial wall of varicose veins thickened,saphenous vein muscle layer and fibrous connective tissue grew unevenly,while hypertensive splenic vein muscle layer and fibrous connective tissue grew evenly.The positive rate of MMP-2 and MMP-9 in the varicose group were 85.4% and 90.2% respectively,while the positive rate of MMP-2 and MMP-9 in the normal group were 35.6% and 60.8%,which has significant difference(P<0.05)between the varicose group and the control group.Conclusion The morphological changes of the membrane and the high expression of MMP-2 and MMP-9 in the spleen vein and varicose veins are associated with the changes of pathological venous wall structure and pressure.