基质金属蛋白酶-2mmp-2 基质金属蛋白酶-9mmp-9对人颈内动脉粥样硬化斑块 稳定性影响的研究-study on the influence of matrix metalloproteinase - 2 mmp - 2 matrix metalloproteinase - 9mm p - 9 on the stability of human carotid atherosclerotic plaques.docx

目录中文摘要················································································1英文摘要················································································3英文缩写················································································6研究论文基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)对人颈内动脉粥样硬化斑块稳定性影响的研究前言···············································································7材料与方法······································································9结果···············································································12附图···············································································13附表···············································································19讨论···············································································20结论···············································································22参考文献·········································································23综述基质金属蛋白酶对动脉粥样硬化斑块影响的研究····················25致谢·····················································································45个人简历···············································································46基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)对人颈内动脉粥样硬化斑块稳定性影响的研究摘要目的：颈动脉狭窄是指因各种原因造成颈动脉内膜的损害，使血液中的脂质物质和血细胞沉积，从而引起血管内膜连续性中断以及血管内膜平滑肌细胞的增生，因为结缔组织的增长、碳酸钙以及胆固醇的沉积、蛋白聚糖和胶原蛋白的不断聚集使动脉壁的正常结构被破坏，动脉血管管径变细，整个动脉失去弹性[1]。基质金属蛋白酶-2（MMP-2）又称为明胶酶A，它在人体内普遍表达，能够降解多种胶原、明胶以及基底膜成分，在血管平滑肌细胞的迁移和增殖过程中发挥着重要的作用[2]。MMP-2可以将I型、II型胶原蛋白特异性的分解为更小的片段[3]，并且降解多种细胞外基质，包括纤维连接蛋白、弹性蛋白、蛋白多糖等。MMP-2的胶原酶活性在溶液中与MMP-1等其他基质金属蛋白酶相比，活性相对较低，然而MMP-2的前体可以在细胞表面发挥高效率降解胶原蛋白的作用[4]。基质金属蛋白酶-9（MMP-9）也是基质金属蛋白酶（MMPs）家族中的一员，又称为明胶酶B，是降解细胞外基质的主要酶类之一，MMP-9主要在斑块基底部血管中膜、粥样斑块、粥样硬化损伤处的平滑肌细胞、血管内皮细胞和巨噬细胞中表达[5]，而且在血管再生过程中MMP-9也发挥着重要作用[6]。但是，MMP-2、MMP-9与颈动脉粥样硬化斑块稳定性关系的临床研究相对偏少，我们设计并实施了本实验，探索MMP-2、MMP-9在人颈内动脉粥样硬化斑块中的表达特点以及二者与颈动脉粥样斑块稳定性的关系。方法：1选取实验标本河北医科大学第二医院神经外科2014年3月～2015年9月颈内动脉内膜剥脱术后留取的斑块标本43例，HE染色后在光镜下将斑块组织分为不稳定性斑块组20例，其中男性17例，女性3例，平均年龄66.4岁；稳定性斑块组23例，其中男性19例，女性4例，平均年龄59.9岁。2人颈内动脉粥样