老年人钙化主动脉瓣中基质金属蛋白酶和细胞凋亡的表达及意义

目的研究基质金属蛋白酶2(MMP-2)及基质金属蛋白酶组织抑制剂2(TIMP-2)和细胞凋亡在主动脉瓣钙化病理过程中的作用。方法选择行主动脉瓣置换术、且主动脉瓣钙化的患者15例作为钙化组,同期选择相同手术、且主动脉瓣正常的患者10例作为非钙化组。术中取主动脉瓣组织,免疫组织化学染色检测MMP-2和TIMP-2表达、TUNEL检测细胞凋亡。结果与非钙化组比较,钙化组主动脉瓣MMP 2、TIMP-2为中、重度着色,阳性细胞显著增多,差异有统计学意义(P<0.01)。钙化组主动脉瓣细胞凋亡指数较非钙化组明显增多(0.71±9.07 vs0.21±6.83,P<0.05)。结论老年钙化主动脉瓣MMP 2和TIMP 2表达异常增高,细胞凋亡数明显增多。

The expression and significance of matrix metalloproteinase and apoptosis in the calcific aortic valve of the aged

Objectives To investigate the expression and significance of matrix metalloproteinase-2 (MMP-2) and apoptosis in the calcific aortic valve.To probe the pathogenesis leading to the development of calcific aortic valve initially.Methods Twenty-five aortic valve replacement patients were divided into 2 groups:15 cases in aortic valve calcification group,10 patients in without calcification group.MMP-2 and TIMP-2 in the valves of the 2 groups were studied by immunohistochemistry. The apoptosis index(AI) was calculated with TUNEL.Results Calcific valve showed dense collagen fiber hyperplasia,blurred border,degeneration,trivial calcium salt deposits in the valve base degenerated area.The expression of MMP-2 and TIMP-2 was significantly higher in calcific valve group than in without calcification group(P<0.01).Positive cells were mostly localized in sub-endothelial and extracellular matrix.AI in the calcific valve group was significantly increased compared with without calcification group(0.71±9.07 vs 0.21±6.83,P<0.05).Conclusions MMP-2,TIMP-2 and apoptosis were significantly increased in elderly calcific aortic valve.