基质金属蛋白酶-9在急性胰腺炎相关性肺损伤中表达的研究

目的 探讨基质金属蛋白酶-9在急性胰腺炎相关性肺损伤中的表达及其临床意义。方法 SD大鼠腹腔注射L-精氨酸制备急性坏死型胰腺炎(ANP)模型。透射电镜下观察肺脏组织超微结构改变；采用免疫组化法分析MMP-9在大鼠肺脏、胰腺组织中的表达及定位。对ANP死亡患者尸检的肺脏和胰腺标本蜡块进行HE染色和免疫组化分析。结果 透射电镜观察ANP大鼠肺泡基底膜水肿、坏死、断裂,肺脏间质水肿、坏死、大量粒细胞浸润,毛细血管内皮水肿、坏死、断裂；免疫组化结果显示肺间质、基底膜及间质浸润的炎症细胞和胰腺间质、基底膜均MMP-9表达阳性。ANP尸检标本胰腺和肺脏组织有明显的坏死和结构破坏,且MMP9表达阳性。结论 MMP-9在ANP大鼠和死亡患者胰腺和肺脏组织表达均阳性,MMP-9可能在APALI的发病过程中起着重要作用。

Expression of matrix metalloproteinase-9 in acute pancreas associated lung injuryDONG Wen-Zhu, LI Zhao-Shen, SONG Jian, WU Xiao-Qing, LU Qing, WANG Qun-Ying, ZHANG Hua-Lian.

Objective To investigate the expression and clinical signficance of matrix metalloproteinase-9 (MMP-9) in acute pancreas associated lung injury (APALI). Methods Acute nerotizing pancreatitis(ANP) was induced in SD rats by intraperitoneal injection of L-argimne and the consequent pulmonary injury was characterized. The morphological changes of lung were observed under transmission electron microscope. The expression and location of MMP-9 protein in ANP pancreas and lung were detected by immunohistochemisty. MMP-9 was examined by immunohistochemistry and histochemis- try in tissue removed at necropsy of ANP. Results Electron microscopy was more helpful and revealed a dramatic and widespread injury to the alveolar capillaries. Alveolar capillary endothelial cells have the features of acute injury; blebbing and separation from the basement membrane are present, and areas of focal necrosis with disruption of the cell membrane were seen. Marked interstitial edema is present with inflammatory cells, particularly neutrophils.MMP-9 was highly expressed in pulmonary interstitial,basement membrane,interstitial infiltration of inflammatory cells, and,to a lesser degree,in pancreatic mesenchymal and basement membrane.MMP-9 was positive in pancreas and lung tissue removed at necropsy of ANP, while negative in control. Conclusions: These findings suggest an important role for MMP-9 in APALI.