组织蛋白酶抑制剂胱抑素C的表达和炎性反应在腹主动脉瘤发病中的意义  

Significance of cathepsin inhibitor Cystatin C expression and inflammatory response in the pathogenesis of abdominal aortic aneurysm

作　　者：秦彦文[1,2] 曹旭[1,2] 方微[3] 刘静[1,4] 张耀中[1,2] 王淼[1,4] 

机构地区：[1]首都医科大学附属北京安贞医院 [2]北京市心肺血管疾病研究所心血管生物研究室,北京100029 [3]首都医科大学附属北京安贞医院病理科,北京100029 [4]北京市心肺血管疾病研究所流行病研究室,北京100029

出　　处：《新乡医学院学报》2013年第1期1-4,8,共5页Journal of Xinxiang Medical University

基　　金：国家自然科学基金资助项目(编号:81070251;81100222;81270389)

摘　　要：目的探讨组织蛋白酶抑制剂胱抑素C(Cystatin C)和炎性反应在腹主动脉瘤(AAA)发病中的意义。方法收集31例AAA患者(AAA组)和32例非AAA患者(对照组)的血浆和AAA组的病变样本,免疫组织化学法检测AAA组病变组织中Cystatin C的表达和巨噬细胞表面抗原2(Mac-2)的含量;酶联免疫吸附法测定AAA组和对照组血浆的Cystatin C水平,常规生物化学法检测血脂、血糖水平,采用免疫散射比浊法检测超敏C反应蛋白(hs-CRP)水平。结果对照组血管动脉壁高表达Cystatin C,而AAA组血管动脉壁的Cystatin C表达显著降低(P<0.01),同时Mac-2表达较对照组显著增加(P<0.01);AAA组患者血浆Cystatin C水平为(32.55±17.31)μg.L-1,显著低于对照组的(78.13±43.13)μg.L-1,2组比较差异有统计学意义(P<0.01),且与AAA直径呈显著负相关(r=-0.560,P<0.01);AAA组患者hs-CRP水平较对照组显著升高,与AAA直径大小呈显著正相关(r=0.762,P<0.01);血浆Cystatin C与hs-CRP水平显著负相关(r=-0.530,P<0.01);多元线性逐步回归分析结果显示,在校正了与AAA直径大小的相关因素后,Cystatin C和hs-CRP水平与AAA直径大小独立相关(P<0.05,0.01)。结论血浆Cystatin C联合hs-CRP水平检测结果可作为判断AAA炎性反应的参考指标。Objective To investigate the significance of the cathepsin inhibitor C （ Cystatin C） and the level of the inflammatory response in the pathogenesis of abdominal aortic aneurysm （AAA）. Methods The plasma of 31 cases with AAA （ AAA group） and 32 cases of non-AAA（ control group） and AAA lesions samples were collected. The expression of Cystatin C and maerophage marker（ Mac-2 ） in AAA lesions tissue were detected by immunohistochemistry. Plasma Cystatin C levels in AAA group and control group were detected by enzyme-linked immunosorbent assay. Blood lipids and sugar levels were detected by conventional biochemical assay and high-sensitivity C-reactive protein（hs-CRP） levels were detected by immunonephelometry. Results The expression of Cystatin C in artery wall of control group was significantly higher than that of AAA group （ P 〈 0.01 ）, but the expression of Mac-2 in control group was significantly lower than that in AAA group（ P 〈 0.01 ）. The plasma Cystatin C level in AAA group was significantly lower than that in control group[ （32.55± 17.31 ） μg · L-1 vs （78.13 ±43.13 ） μg · L-1 （P 〈 0.01 ）. The Cystatin C expression was negative correlation with AAA diameter size（ r = -0.560,P 〈 0.01 ）. The hs-CRP levels in AAA group were significantly higher than those in control group ,and the hs-CRP levels were significantly positive correlated with AAA diameter（ r =0. 762 ,P 〈0.01 ）. The Cystatin C was negatively correlated with hs-CRPlevels（r = -0. 530,P 〈0.01 ）. Multiple linear regression analysis showed that Cystatin C and hs-CRP levels were independently associated with AAA diameter（P 〈 0.05,0.01 ）. Conclusion Combined detection of plasma Cystatin C and hs-CRP levels can be as reference indicators of the inflammatory response of AAA.

关 键 词：腹主动脉瘤 组织蛋白酶 胱抑素C 炎性反应 超敏C反应蛋白 巨噬细胞 

分 类 号：R730[医药卫生—肿瘤]