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目的:探讨基质金属蛋白酶-9(MMP-9)及纤溶酶原激活物抑制物-1(PAI-1)在动静脉内瘘血管内皮中的表达及其对动静脉内瘘功能的影响。方法:纳入20例血液透析患者的失功内瘘及16例新建内瘘,用手术剪切的方法采集血管标本。通过免疫组织化学技术,在蛋白质水平检测36例动静脉内瘘血管内皮细胞中的MMP-9和PAI-1的变化。结果:MMP-9在正常动静脉内瘘血管内皮细胞中微量表达;在失功动静脉内瘘血管内皮细胞中,MMP-9阳性表达明显增多(1.43%vs23.32%,P<0.01)。PAI-1在正常动静脉内瘘血管内皮细胞中微量表达,在失功动静脉内瘘血管内皮细胞中有少量表达(2.28%vs4.62%,P>0.05)。结论:MMP-9在闭塞动静脉内瘘血管内皮细胞中表达明显增多。PAI-1在失功动静脉内瘘血管内皮细胞中表达无明显增多。MMP-9的异常表达可能是影响血液透析患者动静脉内瘘功能的重要因素之一。
Objective: To investigate the expression of matrix metalloproteinase-9 (MMP-9) and plasminogen activator inhibitor-1 (PAI-1) in vascular endothelium of arteriovenous fistula and its effect on arteriovenous fistula. Methods: 20 cases of hemodialysis patients with failed fistula and 16 cases of newly built fistula were enrolled in this study. Surgical shearing was used to collect blood vessel specimens. Immunohistochemistry was used to detect the changes of MMP-9 and PAI-1 at the protein level in 36 cases of arteriovenous fistula vascular endothelial cells. Results: MMP-9 was slightly expressed in the vascular endothelial cells of the normal arteriovenous fistula. The positive expression of MMP-9 was significantly increased in the vascular endothelial cells with arteriovenous fistula (1.43% vs 23.32%, P <0.01). PAI-1 was slightly expressed in the vascular endothelial cells of normal arteriovenous fistulas, and was slightly expressed in vascular endothelial cells of failed arteriovenous fistula (2.28% vs 4.62%, P> 0.05). Conclusion: The expression of MMP-9 in vascular endothelial cells of occlusive arteriovenous fistula obviously increased. There was no significant increase in the expression of PAI-1 in vascular endothelial cells with arteriovenous fistulas. Abnormal expression of MMP-9 may be one of the important factors affecting the function of arteriovenous fistula in hemodialysis patients.