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目的明确明胶酶在弥漫增殖型狼疮肾炎中表达的变化及意义。方法经过肾活检确诊的弥漫增殖型狼疮肾炎17例,分别进行基质金属蛋白酶(MMP)-2与MMP-9的免疫组织化学染色,并进行MMP-2与膜型基质金属蛋白酶(MT1-MMP)、MMP-9与CD68的免疫组织化学双重染色,平均治疗2.5年后行重复肾活检。观察其表达变化与疾病活动度、临床指标以及转归的关系。结果正常对照组可有MMP-2的表达,但是少有MMP-9的表达。弥漫增殖型狼疮肾炎肾组织中MMP-2与MMP-9的表达明显增高,其中MMP-9的表达变化更为显著。MMP-2与MT1-MMP、MMP-9与CD68的表达密切相关。重复肾活检显示10例病情改善者MMP-2与MMP-9的表达分别下降了70%和62%。7例病情未缓解者表达仅下降了27%和32%。MMP-2与MMP-9的表达水平与狼疮肾炎病理活动性指数呈正相关。结论明胶酶的表达与狼疮肾炎病理的活动性密切相关。
Objective To investigate the changes and significance of gelatinase in diffuse proliferative lupus nephritis. Methods 17 cases of diffuse proliferative lupus nephritis diagnosed by renal biopsy were immunohistochemically stained for MMP-2 and MMP-9, and the expressions of MMP-2 and membrane-type matrix metalloproteinase (MT1-MMP) , MMP-9 and CD68 immunohistochemistry double staining, the average treatment of 2.5 years after repeated renal biopsy. To observe the changes in the expression of disease activity, clinical indicators and outcomes. Results The normal control group had MMP-2 expression but few MMP-9 expression. The expression of MMP-2 and MMP-9 in diffuse proliferative lupus nephritis kidney tissues was significantly increased, and the expression of MMP-9 was more obvious. MMP-2 and MT1-MMP, MMP-9 and CD68 expression are closely related. Repeated renal biopsy showed that the expression of MMP-2 and MMP-9 decreased by 70% and 62% respectively in 10 cases. Seven cases of non-remission were only decreased by 27% and 32%. The expression of MMP-2 and MMP-9 was positively correlated with pathological activity index of lupus nephritis. Conclusion The expression of gelatinase is closely related to the pathological activity of lupus nephritis.