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背景:人腹主动脉瘤的发病机制十分复杂,目前尚未完全明了,基质金属蛋白酶9在腹主动脉瘤形成与发展过程中可能具有促进作用。目的:通过检测基质金属蛋白酶9在人腹主动脉瘤组织中的定位表达,评价基质金属蛋白酶9在腹主动脉瘤发病机制中的作用及临床意义。设计:随机对照、重复测量设计。单位:德国科隆大学医院血管外科中心。对象:组织标本选择2002-05/2003-02德国科隆大学医院血管外科中心手术治疗的腹主动脉瘤患者20例,男18例,女2例;年龄56～81岁;随机选择下肢动脉硬化闭塞症血管旁路手术患者15例及其他非血管手术患者10例为对照。方法:同样条件下切取上述患者腹主动脉瘤瘤体组织、下肢动脉硬化闭塞症硬化动脉管壁和正常动脉管壁组织。采用免疫组织化学技术,检测了基质金属蛋白酶9在20例腹主动脉瘤瘤体组织中的定位表达,并与15例下肢动脉硬化闭塞性疾病的病变管壁、10例非血管疾病(正常动脉)管壁组织中的基质金属蛋白酶-组织学表达进行对照研究。主要观察指标:基质金属蛋白酶9在3种不同动脉血管条件下的组织定位表达结果及表达水平。结果:①腹主动脉瘤动脉壁中富含大量基质金属蛋白酶9颗粒,其阳性表达率达95%(19/20)。②正常动脉管壁组织未检测到基质金属蛋白酶9的表达;下肢动脉硬化病变血管壁内可见散在分布的基质金属蛋白酶9阳性颗粒,其阳性表达率为26.7%(4/15)。③与正常动脉管壁和下肢动脉硬化血管壁相比较,基质金属蛋白酶9在腹主动脉瘤瘤体组织中的表达具有显著性差异(P<0.01)。结论:腹主动脉瘤体组织中基质金属蛋白酶9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,在腹主动脉瘤的发病机制中具有重要作用。
BACKGROUND: The pathogenesis of human abdominal aortic aneurysm is very complicated. It is not yet fully understood that MMP-9 may play a catalytic role in the formation and development of abdominal aortic aneurysm. OBJECTIVE: To evaluate the role of matrix metalloproteinase 9 in the pathogenesis of abdominal aortic aneurysms and its clinical significance by detecting the expression of MMP-9 in human abdominal aortic aneurysms. Design: Randomized, repeatable measurement design. Unit: Cologne University Hospital Vascular Surgery Center. Subjects: Tissue samples were selected from 2002-05 / 2003-02 Department of Vascular Surgery, Cologne University Hospital Surgery in Germany 20 patients with abdominal aortic aneurysm, 18 males and 2 females; aged 56 to 81 years; randomized lower extremity arteriosclerosis occlusion 15 cases of symptomatic vascular bypass surgery and 10 cases of non-vascular surgery patients as a control. Methods: Under the same conditions, the abdominal aortic aneurysm tissues and the arterial wall of lower extremity arteriosclerosis obliterans were harvested and harvested. Immunohistochemistry was used to detect the expression of matrix metalloproteinase 9 in 20 cases of abdominal aortic aneurysm tumor tissue. The results were compared with 15 cases of diseased vessel wall of lower extremity arteriosclerotic occlusive disease and 10 cases of non-vascular disease (normal artery ) Tube wall tissue in a control study. MAIN OUTCOME MEASURES: Tissue-localized expression and expression level of matrix metalloproteinase-9 in three different arterial conditions. Results: ①Abdominal aortic aneurysm wall rich in a large number of matrix metalloproteinase 9 particles, the positive rate of 95% (19/20). ② The expression of matrix metalloproteinase 9 was not detected in the normal artery wall tissue. The matrix metalloproteinase 9 positive particles scattered in the arterial wall of lower extremity arteriosclerotic lesions showed a positive rate of 26.7% (4/15). ③ Compared with the normal artery wall and lower extremity vascular wall, the expression of MMP-9 in the abdominal aortic aneurysm tissue had significant difference (P <0.01). Conclusion: The high expression of matrix metalloproteinase 9 in abdominal aortic aneurysm can promote the disintegration of extracellular matrix in the aorta, leading to the decrease of arterial elasticity, arterial dilatation and further tumor formation. In the pathogenesis of abdominal aortic aneurysm Has an important role.