腹主动脉瘤患者血浆MMP-9含量测定及其意义

目的 初步探讨基质金属蛋白酶 9(MMP 9)在腹主动脉瘤 (AAAs)致病机制中的作用。方法 采集 2 0 0 2年 2月至2 0 0 2年 8月德国科隆大学医院血管外科中心收治的 35例AAAs患者治疗前后的血液标本 ,利用酶联免疫分析方法(ELISA)逐一测定血浆MMP 9含量 ,并检测同期住院的 10例动脉硬化闭塞性疾病 (AODs)患者的血浆MMP 9含量作为对照。结果 AAAs患者术前血浆MMP 9含量明显高于AODs患者 [(90 .2 5± 9.12 ) μg·L-1vs.(2 3.5 8± 7.33) μg·L-1,P <0 .0 5 ],治疗后 1月血浆MMP 9含量明显下降 ,与术前相比有显著差异 [(2 8.5 5± 8.35 ) μg·L-1vs.(90 .2 5± 9.12 ) μg·L-1,P <0 .0 5 ],而与AODs患者无显著差别 [(2 8.5 5± 8.35 ) μg·L-1vs.(2 3.5 8± 7.33) μg·L-1,P >0 .0 5 ]。AODs患者治疗前后的MMP 9血浆水平无明显变化 [(2 3.5 8± 7.33) μg·L-1vs.(2 5 .2 8± 5 .78) μg·L-1,P >0 .0 5 ]。结论 腹主动脉瘤患者血浆MMP 9水平的明显升高 ,提示MMP 9与腹主动脉瘤的发病有密切关系 ;动态监测MMP 9含量变化有望成为腹主动脉瘤的早期诊断及术后疗效判断的重要手段。

Elevated plasma level of matrix metalloproteinases-9 and its significance in patients with abdominal aortic aneurysms

Objective: To investigate the changes of the plasma level of MMP-9 (Matrix Metalloproteinase-9, MMP-9) in the patients with abdominal aortic aneurysms (AAAs) before and after the treatment, and evaluate the significance of MMP-9 in the pathogenesis of AAAs. Methods: Blood samples of 35 patients with AAAs and 10 patients with the arterial occlusive diseases (AODs) , which enrolled into the Vascular Surgery Center of Colonge University Hospital from February to August of 2002, were collected before and one month after surgical repair or less-invasive endovascular exclusion. The plasma concentrations of MMP-9 of all the collected samples were measured by means of enzyme-linked immunosorbent assay(ELISA), and compared between the two groups patients at different time point. Results: The mean plasma concentration of MMP-9 of AAAs was significantly higher than that of AODs prior to treatment [(90.3±9.1) ng/ml vs (23.6±7.3) ng/ml, P<0.05], and no apparent difference was showed in the patients with AODs [(23.6±7.3) ng/ml vs (25.3±5.8) ng/ml, P>0.05)] before and after the surgical bypass operation. However, in the patients with AAAs the plasma concentration of MMP-9 was apparently decreased one month after the surgical repair or endovascular exclusion compared with before [(28.6±8.4) ng/ml vs (90.3±9.1) ng/ml, P<0.05)]. No meaningful difference of the mean plasma MMP-9 concentration was seen between two groups after the both being successfully treated [(28.6±8.4) ng/ml vs (25.3±5.8) ng/ml, P>0.05]. Conclusion: Apparent elevation of plasma concentration of MMP-9 in the AAAs and its dramatic decrease after being treated implicated that MMP-9 might play an important role in the formation and development of AAAs. Meanwhile, to investigate the changes of MMP-9 level of AAAs could provide an practical way to facilitate the earlier diagnosis and long term surveillance for AAAs. More importantly, pharmacologic prevention and treatment of AAAs, in which the MMP-9 serves as effective target, might be possible in the future.

EXPRESSION OF MATRIX METALLOPROTEINASE-9 IN HUMANABDOMINAL AORTIC ANEURYSMAL TISSUES

Objective To study the effects of MMP-9 (Matrix Metalloproteinase-9, MMP-9) in the pathogenesis of abdominal aortic aneurysms (AAAs) by localizing the expression of MMP-9 in the aneurysmal tissues. Methods By means of immunohistochemistry, the frozen sections(5 μ m) with aneurysmal tissues (n=10) were incubated with MMP-9 antibody-added agents, then the sections were stained and observed under the microscope to localize the expression of MMP-9, which displayed a brown precipitate within the arterial walls. The normal arterial wall tissues(n=10) and the diseased arterial wall tissues from the arterial occlusive diseases (AODs) (n=15) were also immunized exactly the same way as control. Results A quantity of positive granules which appeared within the aortic media showed the strong expression of MMP-9 in the AAAs, with the positive rate reaching 95%(19/20), while no expression of MMP-9 was observed in the normal artery. However, the scattered distributed positive granules were seen within the arterial wall of some cases of the AODs, implying the weak positive expression of MMP-9 in this disease with the positive rate of 26.7%(4/15). There was a significant difference of the expression of MMP-9 within the arterial wall between the AAAs and AODs(P<0.01). Conclusion High expression of MMP-9 within the aortic media faciliatates the degradation of collagen and elastin fibres and subsequent dilation of the aortic artery ,thus playing an important role in the pathogenesis of AAAs. To refrain MMP-9 from enhanced expressing within the aortic wall is of clinical significance in the prevention and treatment of AAAs.

基质金属蛋白酶-9在腹主动脉瘤体组织中的表达及其临床意义

目的通过检测基质金属蛋白酶9(MMP9)在人腹主动脉瘤(AAAs)组织中的定位表达,探讨MMP9在腹主动脉瘤发病机制中的作用及临床意义。方法应用免疫组织化学技术,检测了MMP9在20例AAAs瘤体组织中的定位表达,并与15例动脉硬化闭塞性疾病(AODs)的病变管壁及10例正常动脉管壁组织中的MMP9组织学表达进行对照研究。结果AAAs动脉壁中富含大量MMP9颗粒,MMP9阳性表达率达95.0%(19/20);正常动脉管壁组织未检测到MMP9的表达;AODs病变血管壁内可见散在分布的MMP9阳性颗粒,MMP9阳性表达率为26.7%(4/15)。与AODs和正常动脉管壁相比较,MMP9在AAAs瘤体组织中的表达差异具有意义(P<0.01)。结论腹主动脉瘤体组织中MMP9的高表达,促进主动脉中层细胞外基质崩解进而导致动脉弹性下降、动脉扩张及进一步的瘤体形成,在AAAs的发病机制中具有重要作用。