中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
20期
9116-9120
,共5页
丛金鹏%董蕾%张馨文%于文成
叢金鵬%董蕾%張馨文%于文成
총금붕%동뢰%장형문%우문성
肺疾病,慢性阻塞性%基质金属蛋白酶9%金属蛋白酶1组织抑制剂%血管重建
肺疾病,慢性阻塞性%基質金屬蛋白酶9%金屬蛋白酶1組織抑製劑%血管重建
폐질병,만성조새성%기질금속단백매9%금속단백매1조직억제제%혈관중건
Pulmonary disease,chronic obstructive%Matrix metalloproteinase 9%Tissue inhibitor of metalloproteinase-1%Revascularization
目的：探讨慢性阻塞性肺疾病患者肺血管中基质金属蛋白酶-9（MMP-9）及其组织金属蛋白酶抑制剂-1（TIMP-1）的表达与肺血管重建的关系及临床意义。方法取60例因肺鳞癌行肺叶切除的癌旁组织标本，其中慢性阻塞性肺疾病组30例和对照组30例，图像分析系统测定肺动脉管壁面积/管总面积（WA%）、管壁厚度/血管外径（WT%）。免疫组化法测定肺血管平滑肌细胞MMP-9、TIMP及平滑肌细胞增殖细胞核抗原（PCNA）表达，并分析其与血管重建相关性。结果（1）慢性阻塞性肺疾病组肺血管炎症程度、WA%、WT%显著高于对照组（P＜0.01）。（2）肺血管平滑肌细胞PCNA、MMP-9、TIMP-1的表达水平与对照组相比明显升高（P＜0.01）。（3）相关分析：慢性阻塞性肺疾病组MMP-9、TIMP-1表达水平与血管炎症程度、WA%、WT%及PCNA呈显著正相关（P＜0.01），多重线性回归分析显示MMP-9、TIMP-1表达水平的上调是影响肺血管重建（WA%、WT%）的主要因素（P＜0.01）。结论 MMP-9、TIMP-1表达增强引起细胞外基质异常降解，诱导平滑肌增殖，促进炎症细胞迁移，在肺血管重塑过程中起到了重要作用。
目的：探討慢性阻塞性肺疾病患者肺血管中基質金屬蛋白酶-9（MMP-9）及其組織金屬蛋白酶抑製劑-1（TIMP-1）的錶達與肺血管重建的關繫及臨床意義。方法取60例因肺鱗癌行肺葉切除的癌徬組織標本，其中慢性阻塞性肺疾病組30例和對照組30例，圖像分析繫統測定肺動脈管壁麵積/管總麵積（WA%）、管壁厚度/血管外徑（WT%）。免疫組化法測定肺血管平滑肌細胞MMP-9、TIMP及平滑肌細胞增殖細胞覈抗原（PCNA）錶達，併分析其與血管重建相關性。結果（1）慢性阻塞性肺疾病組肺血管炎癥程度、WA%、WT%顯著高于對照組（P＜0.01）。（2）肺血管平滑肌細胞PCNA、MMP-9、TIMP-1的錶達水平與對照組相比明顯升高（P＜0.01）。（3）相關分析：慢性阻塞性肺疾病組MMP-9、TIMP-1錶達水平與血管炎癥程度、WA%、WT%及PCNA呈顯著正相關（P＜0.01），多重線性迴歸分析顯示MMP-9、TIMP-1錶達水平的上調是影響肺血管重建（WA%、WT%）的主要因素（P＜0.01）。結論 MMP-9、TIMP-1錶達增彊引起細胞外基質異常降解，誘導平滑肌增殖，促進炎癥細胞遷移，在肺血管重塑過程中起到瞭重要作用。
목적：탐토만성조새성폐질병환자폐혈관중기질금속단백매-9（MMP-9）급기조직금속단백매억제제-1（TIMP-1）적표체여폐혈관중건적관계급림상의의。방법취60례인폐린암행폐협절제적암방조직표본，기중만성조새성폐질병조30례화대조조30례，도상분석계통측정폐동맥관벽면적/관총면적（WA%）、관벽후도/혈관외경（WT%）。면역조화법측정폐혈관평활기세포MMP-9、TIMP급평활기세포증식세포핵항원（PCNA）표체，병분석기여혈관중건상관성。결과（1）만성조새성폐질병조폐혈관염증정도、WA%、WT%현저고우대조조（P＜0.01）。（2）폐혈관평활기세포PCNA、MMP-9、TIMP-1적표체수평여대조조상비명현승고（P＜0.01）。（3）상관분석：만성조새성폐질병조MMP-9、TIMP-1표체수평여혈관염증정도、WA%、WT%급PCNA정현저정상관（P＜0.01），다중선성회귀분석현시MMP-9、TIMP-1표체수평적상조시영향폐혈관중건（WA%、WT%）적주요인소（P＜0.01）。결론 MMP-9、TIMP-1표체증강인기세포외기질이상강해，유도평활기증식，촉진염증세포천이，재폐혈관중소과정중기도료중요작용。
Objective To explore the correlation between the expressions of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) and lung revascularization in patients with chronic obstructive pulmonary disease(COPD). Methods Lung tissues from patients with COPD(COPD group, n=30) and those without COPD(non-COPD group, n=30) were obtained from surgically resected specimens.The ratio of the thickness of the wall to the external diameter of the pulmonary arterioles(WT%) and the ratio of the area of the wall to that of the pulmonary arterioles(WA%) were analyzed by computer-based image analysis system. Immunohistochemical technique was applied to investigate the expressions of proliferating cell nuclear antigen(PCNA), MMP-9 and TIMP-1 in vascular smooth muscle cells. Results (1)The inflammatory infiltration degree, WA%, WT% were significantly higher than that of control group(P<0.01). (2)Compared with control group, the expressions of PCNA, MMP-9 and TIMP-1 in vascular smooth muscle cells were increased significantly(P<0.01). (3) Correlative analysis: the expressions of MMP-9 and TIMP-1 had significant positive correlation with inflammatory infiltration degree, WA%, WT% and the expression of PCNA. Multiple linear regression analysis showed that MMP-9(%) and TIMP-1(%) were main influence factors of pulmonary vascular remodeling (WA%, WT%) (P<0.01). Conclusion Highly expressed MMP-9 and TIMP-1 may cause abnormal extracellular matrix degradation, induce proliferation of smooth muscle cells, promote the inflammatory cells immigration, and play an important role in lung revascularization.
