Lehnert B, Wadouh F, Dwenger A
Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, West Germany.
Surg Gynecol Obstet. 1991 May;172(5):345-50.
Aortic elastase and aortic collagenase were assayed in 38 patients who underwent an operation for thoracic or infrarenal aneurysm or infrarenal aortic occlusive disease and in 15 control patients (heart or kidney donors). Elastase was elevated in normal aortas of the infrarenal region (1.10 milliunits per gram, p less than 0.05), and in atherosclerotic descendens aneurysms (1.24 milliunits per gram, p less than 0.05), compared with the ascending aorta, when normal; aneurysmatic specimens revealed similar low elastolytic activities (0.10 milliunits per gram). The highest elastase content was found in infrarenal aneurysms (4.65 milliunits per gram). Collagenase assays yielded no significant differences, although higher activities were extracted from aortas of the infrarenal region. Coexistent atherosclerosis and wall destruction were evaluated by macroscopic and histologic investigation. All infrarenal specimens demonstrated severe atherosclerotic wall degeneration with depletion of elastic fibers. As the atherosclerotic specimens did not differ from normal aortas by protease assay, the higher elastase of infrarenal samples compared with the thoracic aorta suggests a more rapid fiber metabolism in the infrarenal region. The significantly elevated elastolytic activity of infrarenal aneurysms points to the decisive role of elastase in infrarenal aneurysm formation.
对38例接受胸段或肾下动脉瘤手术或肾下主动脉闭塞性疾病手术的患者以及15例对照患者（心脏或肾脏供体）的主动脉弹性蛋白酶和主动脉胶原酶进行了检测。与正常升主动脉相比，肾下区域正常主动脉（1.10毫单位/克，p<0.05）以及动脉粥样硬化性降主动脉瘤（1.24毫单位/克，p<0.05）中的弹性蛋白酶水平升高；动脉瘤标本显示出相似的低弹性溶解活性（0.10毫单位/克）。肾下动脉瘤中的弹性蛋白酶含量最高（4.65毫单位/克）。尽管从肾下区域的主动脉中提取出的胶原酶活性较高，但胶原酶检测结果无显著差异。通过宏观和组织学研究评估了并存的动脉粥样硬化和血管壁破坏情况。所有肾下标本均显示出严重的动脉粥样硬化性血管壁退变以及弹性纤维缺失。由于蛋白酶检测显示动脉粥样硬化标本与正常主动脉无差异，因此与胸主动脉相比，肾下样本中较高的弹性蛋白酶表明肾下区域的纤维代谢更快。肾下动脉瘤中弹性溶解活性显著升高表明弹性蛋白酶在肾下动脉瘤形成中起决定性作用。
