慢性肾小球肾炎患者血清MMP-2表达及临床意义

目的：研究血清基质金属蛋白酶-2(MMP-2)在肾纤维化进展过程中的变化，评价血液中MMP-2在肾脏纤维化诊断中的价值。方法：选择慢性肾小球肾炎患者33例，按照肾脏病理纤维化以及肾小球硬化程度分为增生组(18例)和纤维化组(15例)，另设8例健康体检者为正常对照组。采用明胶酶谱法检测各组血清MMP-2酶原、活酶水平，比较各组血液中MMP-2水平。结果：与对照组比较，增生组MMP-2 活酶水平明显升高(P<0.01)，纤维化组MMP-2活酶水平则降低(P<0.05)。与增生组比较，纤维化组尿蛋白定量(U-pro)降低(P<0.01)，血清纤维蛋白原(FIB)升高(P<0.05)、纤维连接蛋白(FN)升高(P<0.01)，而血脂(CHO、TG)、血肌酐(Scr)水平差异无显著性。结论：血清MMP-2在慢性肾炎发展的不同时期呈现截然相反的水平变化，测定血清MMP-2水平有助于了解疾病的发展及判断预后。

Expression of matrix metalloproteinase-2 in patients with renal fibrosis and its clinical significance

Objective To study the change of matrix metalloproteinase-2 (MMP-2) in the development of renal fibrosis and evaluate the diagnostic value of blood MMP-2 level in renal fibrosis.Methods Thirty three patients with chronic glomerulonephritis were divided into proliferation group(n=18) and fibrosis group(n=15) according to renal fibrosis degree in renal pathology.Another 8 healthy subjects were used as control group.The levels of pro-MMP-2 and MMP-2 in serum were measured with the method of SDS-PAGE enzymography.Then the levels of pro-MMP-2 and MMP-2 in serum were compared between various groups.Results The serum MMP-2 level in proliferation group was much higher than that in control group(P<0.01) and it was lower in fibrosis group than that in control group(P<0.05).Compared with proliferation group,the content of urine protein in fibrosis group decreased obviously(P<0.01),serum fibrinogen level increased markedly(P<0.05),FN increased (P<0.01);there were no obvious differences of plasma lipid and creatinine level(P>0.05).Conclusion There is a significant difference of serum MMP-2 between suffering group and normal control group.Therefore the detection of serum MMP-2 level can be conducive to understand the development of disease and estimate prognosis.