脑动脉瘤病理改变与基质金属蛋白酶(MMPs)的表达

Expression of the matrix metalloprotainases and the pathological changes of cerebral aneurysms

目的 :探索脑动脉瘤的病理改变情况与基质金属蛋白酶MMPs活性是否增高及过度表达导致动脉瘤的形成。方法 :取 15例经手术切除的脑动脉瘤患者标本。对照组年龄相匹配的 10例取自经DSA证实了的非血管性病变的患者标本。常规组织学检查并行明胶酶谱分析检测MMPs的活性 ,作统计学分析。结果 :光镜下动脉瘤组所有标本均已丧失正常血管壁的结构 ,内弹力膜几乎完全消失 ,常见各个阶段的动脉粥样硬化。动脉瘤壁全层可见到淋巴细胞等炎性细胞的浸润。明胶酶谱分析中 ,动脉瘤组MMP2 和MMP9的量分别为 ( 12 2 .99± 17.6 5 )灰度面积·mg-1·dl-1和 ( 4 9.4 6± 6 .6 7)灰度面积·mg-1·dl-1,高于对照组 ,差异有显著性 (P <0 .0 5 )。结论 :颅内囊性动脉瘤存在MMP2 和MMP9增高 ,动脉瘤中膜和内膜见到淋巴细胞等炎性细胞的浸润和正常结构消失。

Objective:To investigation of the expression of the matrix metalloprotainases and the pathophysiological mechanisms of cerebral aneurysms.Methods:The pathological change of the cerebral aneurysm walls which excised from 15 patients undergone craniotomies after aneurysm clipping and 10 normal cerebral arteries were investigated by light microscopy. And MMPs activity in all the specimens were detected with substrate gel zymography.Results:Under light microscopy observation,the cerebral anerrysm specimens showed the structure changes,including disappearance of the internal elastic lamina,infiltration of lymphocytes and macrophages,and atherosclerotic lesions in different stages were common.Substrate gel zymography showed that there were significant difference in MMPs activity in two groups. The MMP 2 and MMP 9 level in cerebral aneurysm group was 122.99±17.65 and 49.46±6.67 gray scale area.mg -1 .dl -1 ,respectively both were significantly higher than the control group.Conclusion:Intracranal aneurysm is an acquired lesion characterized by proliferative and degenerative changes. Our study indicated that the over expression of MMPs induced by some specifically nosogenesis in the local cerebral aneurysms may be responsible for the destruction of the internal elastic laminae of cerebral arteries,and lead to the generation and rupture of the cerebral aneurysms.