基质金属蛋白酶-9及其组织抑制剂-1与尿毒症患者桡动脉血管钙化的关系

目的 研究尿毒症患者桡动脉血管壁上基质金属蛋白酶-9及其组织抑制剂-1的血清含量以及在血管的表达与血管钙化的关系.方法 选择某院行动静脉内瘘术的尿毒症患者120例为尿毒症组,手术时留取废弃的桡动脉;另选择该院133例因上肢外伤行清创手术者为正常对照组,并留取废弃的上肢桡动脉.ELISA法测定血清TIMP-1和MMP-9浓度.应用von Kossa染色判断钙盐沉积程度;应用免疫组化方法测定MMP-9、TIMP-1在血管壁上的表达.结果 尿毒症患者桡动脉血管内膜厚度和桡动脉管壁/血管直径高于对照组,120例尿毒症桡动脉血管标本中出现血管钙化105例,发生率87.5％.钙化的血管中膜MMP-9、TIMP-1表达高于对照组,且和血管钙化程度呈正相关.结论 尿毒症患者普遍存在血管钙化,MMP-9、TIMP-1在尿毒症患者桡动脉的血管壁表达和血管钙化程度相关,提示组织基质金属蛋白酶系统和尿毒症血管钙化密切相关.

Relationship between medial calcification of arteries and the expressions of matrix metallopeptidase 9(MMP-9) and tissue inhibitor ofmetalloproteinase 1(TIMP-1) in uremic patients

OBJECTIVE To study the relationship between the medial calcification of arteries and the expressions of matrix metallopeptidase 9(MMP-9) and tissue inhibitor ofmetalloproteinase 1(TIMP-1) in uremic patients.METHODS Pieces of radial arteries were taken from 120 uremic patients at the time of arteriovenous fistula operation.The control radial arterieswere taken fromtrauma patients with normal kidney function at the time of amputation operation.The level of serum of MMP-9,TIMP-1 were detected by ELISA.Vascular calcification was evaluated histomorphometrically on Von Kossa-stained sections,and the expressions of MMP-9,TIMP-1 were determined immunohistochemically.RESULTS The endangium thickness and tube wall /diameter in uremia group were larger than that of control group.Vascular calcification was found in 105 uremic patients(87.5%).All of the radial arteries with calcification showed positive immunostaining of MMP-9,TIMP-1.The immunostaining of MMP-9,TIMP-1 was positive correlation to the vascular calcification.CONCLUSION That expressions of MMP-9 and TIMP-1 in arteries are correlated to vascular calcification in uremic patients.Our results suggest that the imbalance expression ofMMP-9 /TIMP-1 may cause vascular medial calcification in uremic patients.