The Research On The Expression Of Matrix Metalloproteinase In Acute Aortic Syndrome

Objective To investigate the expression and clinical significance of matrix metalloproteinase-2,8.9,12 in the acute aortic syndrome.Methods 50 patients with acute aortic syndrome from March 2013 to March 2015 in General hospital of tianjin medical university are the research objective(Stanford type A aortic dissection 28 cases, Stanford type B aortic dissection 12 cases, Aortic intramural hematoma and penetrating ulcer 10cases). Patients were divided to AD group and aortic intramural hematoma and penetrating ulcer group according to the different diseases.And according to the different treatment,each group is divided to operation group and conservative group.In the AD group, Surgical patients are 18 cases,TEVAR patients are 8 cases and conservative patients are 5 cases. In aortic intramural hematoma and penetrating ulcer group,TEVAR patients are 5 cases and conservative patients are 5 cases.We choose 20 patients who go to hospital for physical examination at the same period as the control group for the MMP’s research.1. ELISA is used to measure the expression of MMP in plasma between aortic dissection group, the aortic intramural hematoma and penetrating ulcer group and the control group.2. We evaluate the patient’s survival and recovery, the safety of surgical treatment and the change of MMP’s level in the blood plasma by follow-up.Result 1.MMP-2,8,9,12 in the plasma is existed in all groups. In aortic dissection group, the expression of MMP- 8,9,12 is higher than that of control group(P<0.05), no obvious difference was found of the expression of MMP – 2 between the two groups; In aortic intramural hematoma and penetrating ulcer group,the expression of MMP-8,9 in plasma is higher than that of control group(P<0.05), no obvious difference was found of the expression of MMP- 2, 12 between the two groups. 2. The success rate of hybrid surgery for Stanford type A AD is 100%,and one of the patients died during the follow-up, others live well; The success rate of TEVAR treatment for Stanford type B AD and aortic intramural hematoma and penetrating ulcer patients is 100%, and none of patients died during the follow-up. 3. For the surgical patients of Stanford type A AD, the diameter of aorta and false lumen are smaller than that of preoperative after operation in the position of proximal、midpoint and maxium diameter of the aorta(P<0.05), and the expression of MMP- 8,9 level in plasma is less that of preoperative(P<0.05), the expression of MMP- 2, 12 have no obvious difference; For the surgical patients of Stanford type B AD, the diameter of aorta and false lumen are smaller than that of preoperative after operation in the position of proximal、midpoint and maxium diameter of the aorta(P<0.05), and the expression of MMP- 8,9 level in plasma is less that of preoperative(P<0.05), the expression of MMP- 2, 12 have no obvious difference; For the surgical patients of aortic intramural hematoma and penetrating ulcer, the diameter of aorta and hematoma are smaller than that of preoperative after operation in the position of proximal、midpoint and maxium diameter of the aorta(P<0.05), and the expression of MMP- 9 level in plasma is less that of preoperative in a half month and 1-3 months after operation(P<0.05), the expression of MMP- 2, 8,12 have no obvious difference. 4. For the conservative patients of Stanford type B AD, the review of aorta CTA in 1-3 months shows the diameter of the proximal、midpoint、maxium false lumen and maxium diameter of the aorta are larger than that of before(P<0.05),and the expression of MMP- 9 level in plasma is higher than that of before(P<0.05), the expression of MMP- 2, 8,12 have no obvious difference. 5. The correlation analysis results of MMP and various sections of aortic false lumen(hematoma), the true lumen(lumen) diameter shows that MMP-8 and maximum false lumen(hematoma) diameter are positively correlated(P <0.05), MMP-9 and the maximum aortic diameter、maximum false lumen(hematoma) diameter are positively correlated(P <0.05).Conclusion 1. Hybrid operation and TEVAR treatment for the patients of acute aortic syndrome are safe, effective and can prompte the remodeling of aortic with good recent or mid-term results. 2.MMP(especially MMP-8,9) can be used as one of the reference index for the diagnosis of AAS. 3.MMP-8, 9 are likely to be important indicators to estimate the prognosis of acute aortic syndrome.