门静脉高压症脾大部切除后残脾基质金属蛋白酶及其抑制剂的变化

发布时间：2018-08-31 08:20

【摘要】：目的检测门静脉高压症脾大部切除后残脾组织和血清基质金属蛋白酶及其抑制剂的表达和水平,探讨脾纤维化的分子机制及保脾术的临床价值。方法选取门静脉高压脾肿大患者13例。术中切取脾组织为巨脾组,术后8年穿刺获取脾组织为残脾组,设外伤性脾破裂患者13例为对照组。采用免疫组织化学法、实时荧光定量聚合酶链反应(q RT-PCR)及酶联免疫吸附测定(ELISA)检测脾脏组织和血清基质金属蛋白酶MMP-2、MMP-9、组织金属蛋白酶抑制物TIMP-1、TIMP-2的表达和水平。结果 3组脾组织中,MMP-2、MMP-9、TIMP-1、TIMP-2蛋白阳性表达主要分布在巨噬细胞内。残脾组和巨脾组脾组织MMP-2、MMP-9、TIMP-1和TIMP-2蛋白阳性表达率和基因表达与对照组比较,均差异有统计学意义(P0.05),残脾组和巨脾组升高;残脾组和巨脾组之间比较则差异无统计学意义(P0.05)。残脾组和巨脾组血清MMP-2、MMP-9、TIMP-1和TIMP-2水平与对照组比较,均差异有统计学意义(P0.05),残脾组和巨脾组升高;残脾组和巨脾组之间比较差异无统计学意义(P0.05)。结论门静脉高压症脾肿大患者脾大部切除术后残脾组织MMP-2、MMP-9、TIMP-1及TIMP-2蛋白和基因表达增加,血清蛋白水平升高,提示残脾组织基质金属蛋白酶和组织金属蛋白酶抑制物代谢失调。
[Abstract]:Objective to investigate the expression and level of matrix metalloproteinases (MMP-2) and its inhibitors in residual spleen tissue and serum after splenectomy in patients with portal hypertension, and to explore the molecular mechanism of splenic fibrosis and the clinical value of splenic preservation. Methods 13 patients with portal hypertension and splenomegaly were selected. Splenic tissue was removed as giant spleen group during operation, splenic tissue was obtained by puncture for 8 years after operation as residual spleen group, and 13 patients with traumatic splenic rupture were selected as control group. The expression and level of tissue inhibitor of metalloproteinase (TIMP-1,TIMP-2) in spleen and serum were detected by immunohistochemistry, real-time quantitative polymerase chain reaction (RT-PCR) and enzyme linked immunosorbent assay (ELISA). Results the positive expression of MMP-2, MMP-9, TIMP-1 and TIMP-2 in splenic tissues was mainly distributed in macrophages. The positive expression rate of MMP-2,MMP-9,TIMP-1 and TIMP-2 protein and gene expression in residual spleen group and giant spleen tissue were significantly higher than those in control group (P0.05), while there was no significant difference between residual spleen group and giant spleen group (P0.05). The levels of serum MMP-2,MMP-9,TIMP-1 and TIMP-2 in the residual spleen group and the giant spleen group were significantly higher than those in the control group (P0.05), while there was no significant difference between the residual spleen group and the giant spleen group (P0.05). Conclusion the expression of MMP-2,MMP-9,TIMP-1 and TIMP-2 protein and gene and the level of serum protein in splenomegaly after splenectomy in patients with splenomegaly of portal hypertension are increased, suggesting that matrix metalloproteinases and tissue inhibitor of metalloproteinases metabolism are dysfunctional.
【作者单位】：解放军第八十九医院普外中心;潍坊医学院医学研究中心;潍坊医学院研究生部;
【基金】：山东省潍坊市科技发展计划资助项目(No:2014zj1058)
【分类号】：R657.6

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