MMP7、MMP9在先天性肾盂输尿管连接部梗阻发病中的作用  

Roles of MMP7 and MMP9 in the pathogenesis of congenital ureteropelvic junction obstruction

作　　者：杨伟家 谢崇 李水学[1] 周玲[1] 秦双利 Yang Weijia;Xie Chong;Li Shuixue;Zhou ling;Qin Shuangli(Department of Pediatric Surgery,Xinjiang Autonomous Region People Hospital,Urumqi 830001,China;Department of Pediatric Surgery,Xi'an International Medical Center Hospital,Xi'an 710100,China)

机构地区：[1]新疆维吾尔自治区人民医院小儿外科,乌鲁木齐830001 [2]西安国际医学中心医院小儿外科,西安710100

出　　处：《中华小儿外科杂志》2022年第10期906-913,共8页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨MMP7、MMP9在先天性肾盂输尿管连接部梗阻(Congenital ureteropelvic junction obstruction,UPJO)发病中的作用。方法临床研究纳入2019年1月至2020年9月经新疆维吾尔自治区人民医院小儿外科诊断为UPJO患儿28例,其中男22例,女6例,平均年龄为6.5岁,范围为2个月至15岁。按其年龄、性别1∶1匹配28例健康儿童,完善肾动态显像、尿肌酐标准化MMP7、MMP9水平检查,对手术患儿进行随访。实验研究选取清洁级雌性SD大鼠作为研究对象,建立UJPO模型组27只(术后1周组、术后2周组,术后4周组各9只)作为实验组,建立假手术组9只(术后1周组、术后2周组,术后4周组各3只)作为对照组。收集各组肾脏标本,进行免疫组化、Western Blot、QRT-PCR方法分别检测MMP7、MMP9的表达水平。结果UPJO患儿尿肌酐标准化MMP7、MMP9分别为9.66(7.57,12.01)和24.45(19.32,30.19),正常患儿分别为4.66(3.78,5.45)和10.62(8.65,12.37),差异有统计学意义(P<0.05);手术组患儿尿肌酐标准化MMP7、MMP9分别为12.85(9.76,15.71)和31.90(24.62,38.61),非手术患儿为3.94(3.12,4.71)和11.72(8.99,14.41),差异有统计学意义(P<0.05);12例患儿术后6个月尿肌酐标准化MMP7、MMP9分别为2.76(2.07,3.40)和7.39(5.11,9.70),术前分别为7.97(5.49,10.55)和20.59(14.28,27.11),差异有统计学意义(P<0.05)。在动物实验中,通过免疫组化、Western Blot、QRT-PCR检测结果显示:第2周、第4周手术侧肾MMP7、MMP9表达高于假手术组和非手术侧组(P<0.05);手术侧组第4周MMP7、MMP9水平较第1周升高(P<0.05),呈逐渐升高趋势;非手术侧组第4周MMP7水平较第1周升高(P<0.05)。结论尿MMP7、MMP9可作为预测UJPO的一种无创生物标志物,在一定程度上能预测UPJO的临床进程,对UPJO患儿手术时机的把握及预后监测可能有临床价值。Objective To explore the roles of matrix metalloproteinase-7(MMP7)and matrix metalloproteinase-9(MMP9)in the pathogenesis of congenital ureteropelvic junction obstruction(UPJO).Methods From January 2019 to September 2020,28 UPJO children at Xinjiang Uygur Autonomous Region People's Hospital were recruited.According to age and gender,28 healthy children were matched 1∶1.Renal dynamic imaging,standardized urinary creatinine MMP7/MMP9 level and other examinations were performed.In experimental study,female Sprague-Dawley(SD)rats were selected as research subjects.And UJPO model group of 27 rats(1/2/4 weeks post-operation,n=9 each)was established as experimental group and sham operation group of 9 rats(1/2/4 weeks post-operation,n=3 each)as control group.Kidney specimens were collected and the expression levels of MMP7/MMP9 detected by immunohistochemistry,Western blot and quantitative real time-polymerase chain reaction(qRT-PCR).Results The standardized MMP7/MMP9 of urinary creatinine in PJO children were 9.66(7.57,12.01)and 24.45(19.32,30.19)and those in normal children 4.66(3.78,5.45)and 10.62(8.65,12.37)respectively with statistical differences(P<0.05).The standardized MMP7/MMP9 of urinary creatinine were 12.85(9.76,15.71)and 31.90(24.62,38.61)in operation group and 3.94(3.12,4.71)and 11.72(8.99,14.41)in non-operation group with statistical differences(P<0.05).The standardized MMP7/MMP9 of urinary creatinine were 2.76(2.07,3.40)and 7.39(5.11,9.70)at 6 months postoperatively and 7.97(5.49,10.55)and 20.59(14.28,27.11)pre-operation with statistical differences(P<0.05).In animal experiment,the expression of MMP7/MMP9 at operative side was higher than that at sham/non-operative side at week 2/4(P<0.05).The levels of MMP7/MMP9 in operative group at week 4 were higher than those at week 1(P<0.05),showing a gradually rising trend.The level of MMP7 at non-operative side at week 4 was higher than that at week 1(P<0.05).Conclusions Urinary MMP7/MMP9 may be employed as a non-invasive biomarker for predicting UJPO.Capable o

关 键 词：肾盂 肾盂输尿管连接部梗阻 MMP7 MMP9 无创生物标志物 

分 类 号：R726.9[医药卫生—儿科]