慢性肾小球肾炎患者血清MMP-9和TIMP-1的浓度及意义

目的:观察慢性肾小球肾炎血清基质金属蛋白酶9(matrix metalo protein-ase-9,MMP-9)、金属蛋白酶组织抑制剂1(tissue inhibitors of metalloproteinases,TIMP-1)的浓度与肾组织中MMP-9、TIMP-1表达的相关性,探讨慢性肾小球肾炎血清MMP-9、TIMP-1对肾脏纤维化的判断价值。方法:通过肾组织活检病理检查,将入选慢性肾炎的病例分增生组(A组)15例,纤维化组(B组)15例,另选10例志愿者作为健康对照组C组。应用免疫组化法观察A、B两组MMP-9、TIMP-1在肾组织中的表达情况,并且进行半定量分析,比较它们之间有无差别。应用ELISA双抗体夹心法检测A、B、C三组MMP-9、TIMP-1在血清中的浓度,比较它们之间有无差别。观察A、B两组MMP-9、TIMP-1在肾组织中的表达水平与在血清的浓度有无相关性。结果:A、B两组MMP-9在肾小球和肾间质少见表达,主要在肾小管上皮细胞浆中表达增高,两组之间表达的强度有显著差异性;A组TIMP-1在肾小球中少见表达,在肾小管上皮细胞增强。B组TIMP-1在肾小球中有少量表达,在肾小管上皮细胞较A组进一步增强,两组之间表达的强度有显著差异性(P0.05)。血清中MMP-9、TIMP-1浓度在A、B组显著高于C组,血清中MMP-9在A、B两组之间无显著差异性,血清中TIMP-1在A、B、C三组间两两比较有显著差别(P0.05)。结论:慢性肾炎患者血清中MMP-9、TIMP-1浓度与肾脏组织中MMP-9、TIMP-1的表达呈正相关。MMP-9、TIMP-1的相关性分析P值小于0.01。血清MMP-9、TIMP-1参与了肾脏纤维化的进展,慢性肾小球肾炎血清中MMP-9、TIMP-1的浓度可在一定程度上反映肾脏纤维化程度。

Concentration and Significance of MMP-9 and TIMP-1 in Serumof Patients with Chronic Glomerulonephritis

Objective:To explore the relationship between serum MMP-9 and TIMP-1 in serum and the mechanism of renal fibrosis by means of detecting the concentrations and expressions of MMP-9 and TIMP-1 in serum of patients with chronic glomerulonephritis.Methods:30 patients with chronic glomerulonephritis were divided into the proliferation group (group A, n=15) and fibrosis group(group B, n=15) according to renal fibrosis degree in the renal pathology. And another 10 healthy people were chosen as the control group (group C, n=10). The expressions of MMP-9 and TIMP-1 in the renal tissue were detected by the immunohistochemistry and half quantitative analysis. The expressions of MMP-9 and TIMP-1 in the renal tissue between the two groups were compared. Then the relationship between the concentrations of serumMMP-9 and TIMP-1 and the renal disease was analyzed.Results:The expression of MMP-9 was low in the glomerulus and renal interstitial. The expression of MMP-9 was very high in tubular epithelial cells in group A and group B. There was statistically significant differences between two groups (P<0.05). The expression of TIMP-1 was lower in the glomerulus and higher in tubular epithelial cells in group A. The expression of TIMP-1 in tubular epithelial cells in group B was higher than that of group A. There was statistically significant difference between the two groups (P<0.01). The concentration of serum MMP-9 and TIMP-1 was significantly higher than that in the control group (P<0.05; P<0.01). There was no statistically significant difference in the concentrations of MMP-9 between group A and group B (P>0.05). The expression of TIMP-1 in the renal tissue has a positive correlation with the level of TIMP-1 in serum of patients (r=0.489).Conclusion:The level of serum MMP9 and TIMP-1 were positively correlated with the expressions in renal tissue. The concentration of MMP-9 and TIMP-1 in serum could reflect the renal fibrosis degree of patients with the chronic glomerulonephritis.