van Laake L W, Vainas T, Dammers R, Kitslaar P J E H M, Hoeks A P G, Schurink G W H
Department of Surgery, University Hospital Maastricht, 6202 AZ Maastricht, The Netherlands.
Eur J Vasc Endovasc Surg. 2005 Apr;29(4):371-7. doi: 10.1016/j.ejvs.2005.01.009.
Accumulating evidence suggests that patients with abdominal aortic aneurysm (AAA) suffer from a systemic dilating condition affecting all arteries. Matrix metalloproteinases (MMPs) and their natural inhibitors, the tissue inhibitors of metalloproteinases (TIMPs), appear to be involved in aneurysm formation, as evidenced by increased aortic tissue MMP activity and plasma MMP levels in patients with AAA. Hypothesizing that an imbalance in plasma MMP/TIMP level might be associated with a systemic dilation diathesis, we studied mechanical vessel wall properties of non-affected arteries of patients with either AAA or aorto-iliac obstructive lesions in association with plasma MMP-9 and TIMP-1 levels.
Twenty-two patients with AAA and 12 with aorto-iliac occlusive disease (AOD) were included. Diastolic diameter (d) and distension (Deltad) were measured at the level of the common carotid artery (CCA) and suprarenal aorta (SA) using ultrasonography. Distensibility (DC) and compliance (CC) were calculated from d, Deltad and brachial pulse pressure. Plasma MMP-9 and TIMP-1 were determined with specific immunoassays.
The average (+/-SD) age was 72.3+/-5.6 and 65.0+/-8.2 years for the AAA and AOD patients, respectively, (P=0.005). CCA diameter was 9.1+/-1.3mm in AAA patients and AOD 7.8+/-1.4mm in AOD patients, P=0.009. This difference persisted after correction for age. Plasma MMP-9 and TIMP-1 did not differ significantly between AAA and AOD patients. In the total 34 patients, the MMP-9/TIMP-1 ratio was correlated inversely with distensibility (r=-0.74, P=0.002) and to compliance (r=-0.58, P=0.024) of the suprarenal aorta.
The CCA diameter was larger in AAA patients compared to AOD patients. MMP-9/TIMP-1 ratio was associated with decreased distensibility and compliance of the suprarenal aorta. These data support the idea that AAA patients exhibit a systemic dilation diathesis, which might be attributable to MMP/TIMP imbalances.
越来越多的证据表明，腹主动脉瘤（AAA）患者患有影响所有动脉的全身性扩张性疾病。基质金属蛋白酶（MMPs）及其天然抑制剂金属蛋白酶组织抑制剂（TIMPs）似乎参与了动脉瘤的形成，AAA患者主动脉组织MMP活性增加和血浆MMP水平升高证明了这一点。假设血浆MMP/TIMP水平失衡可能与全身性扩张素质有关，我们研究了AAA或主-髂动脉阻塞性病变患者未受影响动脉的血管壁力学特性，并分析了其与血浆MMP-9和TIMP-1水平的关系。
纳入22例AAA患者和12例主-髂动脉闭塞性疾病（AOD）患者。使用超声在颈总动脉（CCA）和肾上腺主动脉（SA）水平测量舒张期直径（d）和扩张度（Δd）。根据d、Δd和肱动脉脉压计算扩张性（DC）和顺应性（CC）。采用特异性免疫测定法测定血浆MMP-9和TIMP-1。
AAA患者和AOD患者的平均（±标准差）年龄分别为72.3±5.6岁和65.0±8.2岁（P=0.005）。AAA患者的CCA直径为9.1±1.3mm，AOD患者为7.8±1.4mm，P=0.009。校正年龄后，这种差异仍然存在。AAA患者和AOD患者之间的血浆MMP-9和TIMP-1没有显著差异。在总共34例患者中，MMP-9/TIMP-1比值与肾上腺主动脉的扩张性（r=-0.74，P=0.002）和顺应性（r=-0.58，P=0.024）呈负相关。
与AOD患者相比，AAA患者的CCA直径更大。MMP-9/TIMP-1比值与肾上腺主动脉扩张性和顺应性降低有关。这些数据支持AAA患者表现出全身性扩张素质的观点，这可能归因于MMP/TIMP失衡。
