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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。
Objective To study the serum levels of matrix metalloproteinase-9 and tissue inhibitor-1 in the radial artery wall of patients with uremia and its relationship with vascular calcification. Methods One hundred and twenty patients with uremia who underwent arteriovenous fistula operation in one hospital were treated with uremia group, and the abandoned radial artery was taken at the time of operation. The other 133 patients with debridement operation due to upper limb trauma were selected as normal control group, Take the abandoned upper limb radial artery. Serum TIMP-1 and MMP-9 concentrations were measured by ELISA. The degree of calcium deposition was determined by von Kossa staining. The expression of MMP-9 and TIMP-1 in the vascular wall was detected by immunohistochemistry. Results The radial artery intima-media thickness and radial artery wall / vessel diameter in uremic patients were higher than those in the control group. 105 cases of vascular calcification occurred in 120 cases of uremia radial artery vessels, the incidence rate was 87.5%. The expression of MMP-9 and TIMP-1 in calcified vascular intima was higher than that in control group, and was positively correlated with the degree of vascular calcification. Conclusions Vascular calcification is common in patients with uremia. The expression of MMP-9 and TIMP-1 in the radial artery of uremic patients is correlated with the degree of vascular calcification, suggesting that the relationship between tissue MMPs and vascular calcification of uremia is closely related.