急性脑梗死患者血清基质金属蛋白-9水平的动态变化及临床意义  

Dynamic changes of serum levels of MMP-9 in patients with acute cerebral infarction and their clinical significance

作　　者：寇忠爱[1] 相波[1] 赵仁亮[2] 

机构地区：[1]青岛大学医学院 [2]青岛大学医学院附属医院脑科医院神经内科,山东青岛266000

出　　处：《临床荟萃》2007年第1期6-9,共4页Clinical Focus

摘　　要：目的探讨急性脑梗死患者血清中基质金属蛋白酶-9(MMP-9)水平的动态变化及其临床意义。方法选取首次发病的24小时以内的颈内动脉系统急性脑梗死患者80例。采用双抗体夹心酶联免疫吸附法(ELISA法)测定其发病后1天、2天、4天、8天、12天血清MMP-9浓度。与健康对照者比较。结果急性脑梗死患者血清MMP-9水平于发病后1天、2天、4天、8天、12天分别为(261.7±128.4)μg/L、(382.8±151.6)μg/L、(302.7±138.4)μg/L、(283.5±121.3)μg/L、(236.6±112.9)μg/L,与对照组水平(147.1±108.6)μg/L比较均明显升高,差异有统计学意义(P<0.01),以发病后2天水平升高尤著,此后呈逐渐降低的趋势。大梗死灶组患者发病后2天血清MMP-9水平高于中、小梗死灶组(F=6.179,P<0.01),3组之间比较差异均有统计学意义。脑梗死灶大小与急性脑梗死患者发病后2天血清MMP-9水平呈直线正相关(r=0.482,P<0.001)。神经功能缺损评分减少值与急性脑梗死患者发病后2天血清MMP-9水平呈直线负相关(r=-0.536,P<0.001)。预后不良组血清MMP-9水平各时间点均高于预后良好组。结论急性脑梗死患者发病早期血清MMP-9水平明显升高,提示MMP-9可能参与了急性脑梗死的发病机制。急性脑梗死患者脑梗死灶越大、脑损伤越重,血清MMP-9升高越明显。血清MMP-9水平可能对病情的严重程度和预后有预示作用。Objective To investigate the dynamic changes of serum levels of matrix metalloproteinase-9 （MMP- 9） in patients with acute cerebral infaretion（ACI） and evaluate their clinical significance. Methods 80 eases of ACI in the internal earotid artery systerm within 24 hours after the onset were recruited into this study. The blood samples were collected at days 1, 2, 4, 8 and 12 after stroke onset. Serum eoneentrations of MMP-9 were measured by enzymelinked immunosorbent assay. 50 healthy persons were used as control subjects. Results The serum MMP-9 levels in ACI patients were （261.7±128.4） μg/L, （382.8±151.6） μg/L, （302. 7±138.4） μg/L, （238.5±121.3） μg/L and （236.6±112.9） μg/L respectively at ld, 2d, 8d, 12d after the onset. The above serum MMP-9 levels were higher than that of the control, merely （147.1±108. 6） μg/L（ P〈0.01, respectively）. MMP-9 level in the large infarction group was higher than that in the medium or the small infarction group at 2d after stroke onset （ F = 14.67, P 0. 001）. The infarction Size was positively linear relative to the level of MMP-9 at 2d（ r =0. 482, P 〈0. 001）. The decreased clinical neurological deficit scores were negatively correlated with serum MMP-9 level at 2d （ r = -0. 536, P 〈 0. 001）. Patients with bad prognosis had higher MMP-9 level than those with good prognosis at all time points post stroke. Conclusions The MMP-9 level is elevated in the early stage of cerebral infarction. The results suggested that MMP-9 was involved in the aeute phase of isehemie stroke, and the serum level of MMP-9 therefore might have prognostic value to the eerebral isehemia.

关 键 词：脑梗塞 明胶酶B 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]