溶栓治疗急性脑梗死患者血浆基质金属蛋白酶-9含量变化及临床意义  

Changes of plasma MMP-9 in patients with acute cerebral infarction before and after thrombolytic therapy by urokinase

作　　者：吉训明[1] 朱榆红[1] 段丽芬[1] 李淑婷[1] 朱凤水[2] 缪中荣[2] 焦力群[2] 牛香美[2] 罗玉敏[1] 

机构地区：[1]首都医科大学宣武医院脑血管病研究室 [2]首都医科大学宣武医院介入中心,北京100053

出　　处：《中风与神经疾病杂志》2008年第4期391-393,共3页Journal of Apoplexy and Nervous Diseases

基　　金：国家自然科学基金资助项目(No30500166);北京市卫生局首都医学发展科研基金(No2005-2050)

摘　　要：目的探讨急性脑梗死患者尿激酶动脉溶栓治疗后血浆基质金属蛋白酶-9(Matrix metalloproteinases-9,MMP-9)的变化及临床意义。方法对20例尿激酶动脉溶栓治疗的急性脑梗死患者MMP-9基础值和溶栓后水平进行测定,比较溶栓前后以及与健康对照组血浆MMP-9水平。结果急性脑梗死患者溶栓后MMP-9水平比对照组和基础值显著升高(P<0.05);溶栓后发生出血性转化的患者MMP-9水平较溶栓前有显著增加(P<0.05),与无出血患者相比有增高趋势但无统计学差异;溶栓后完全再通患者MMP-9较基础值明显升高(P<0.05)。结论尿激酶溶栓可能激活了MMP-9,增加溶栓后出血的风险,并且MMP-9可能参与了脑组织缺血再灌注损伤。Objective To explore the changes of plasma MMP-9 in patients with acute cerebral infarction before and after thrombolytic therapy by urokinase. Methods The levels of MMP-9 were determined in 20 patients with acute cerebral infarction before and after thrombolytic therapy, and 15 healthy individuals served as control. Results As compared with the controls ,the levels of plasma MMP-9 before thrombolytic therapy were not significantly increased（ P 〉 0.05 ）. Nevertheless, MMP-9 values were significantly increased after thrombolytic therapy using urokinase than either before or control group（ P 〈 0.05 ）. MMP-9 values were significantly higher in patients with haemorrhage after thrombolytic therapy compared with before treatment and the controls （ P 〈 0.05 ）, and the values of MMP-9 were higher than those of patients without haemorrhage, but there was no statistical difference （ P 〉 0.05 ）. In completely reperfusion patients, after thrombolytic therapy, MMP-9 level was markedly higher than in no-reperfusion patients （ P 〈 0.05 ）. Conclusions MMP-9 might participate in reperfusion injury of acute cerebral infarction and the mechanisms of hemorrhagic complications in thrombolysis.

关 键 词：溶栓治疗 基质金属蛋白酶-9 尿激酶 

分 类 号：R743.3[医药卫生—神经病学与精神病学]