急性期脑梗死患者血清MMP-9水平动态变化意义及与预后的关系  

Relationship among the level of serum MMP-9 at acutestage of cerebral infarction and the significance in prognosis

作　　者：陶定波[1] 姜秀丽[2] 雷阳[1] 洪晓军[1] 吴丹[1] 孙晓培[1] 

机构地区：[1]大连医科大学附属第一医院神经内科,辽宁大连116011 [2]山东省日照市人民医院神经内科,山东日照276800

出　　处：《中风与神经疾病杂志》2009年第2期176-179,共4页Journal of Apoplexy and Nervous Diseases

基　　金：辽宁省教育厅科研计划项目(No.20060213)

摘　　要：目的通过对急性脑梗死患者不同时间点血清基质金属蛋白酶-9(Matrix Metalloproteinase,MMP-9)的测定和比较,探讨MMP-9水平与脑梗死TOAST分型及预后的关系。方法收集急性脑梗死患者60例,对照组20例,分别测定急性脑梗死患者发病24h内、第5天和第10天的血清MMP-9含量,记录患者入院时的美国国立卫生研究所中风量表(NIHSS)评分;随访6个月,记录发病1个月时和发病6个月时的BI(Barthal Index)来评价预后。结果(1)发病后24h内,脑梗死组TOAST各亚型血清MMP-9含量均升高,与对照组比较差异具有显著性(P<0.05),其中,CE组和LAA组MMP-9含量持续至第5天仍未下降,而SA组已逐渐降至正常水平;第10天各组MMP-9含量均降至正常水平。(2)发病后24h内血清MMP-9含量与相应时段NIHSS评分具有直线相关关系(r=0.883,P<0.01)。(3)预后较好组其发病24h内血清MMP-9含量明显低于预后较差组(P<0.05)。结论(1)脑梗死后各组血清MMP-9的含量升高,但它们的变化趋势不尽相同。(2)发病后24h内MMP-9含量与与病情的严重程度有关。(3)脑梗死后24h内的血清MMP-9含量是预后的独立预测因素。Objective To determine and compare the level of serum MMP-9 at acute stage of cerebral infarction and to approach the relationship among the level of serum MMP-9 and the classification of TOAST and the significance in prognosis.Methods 60 patients with cerebral infarction were included in our study,while 20 healthy people served as the control group. The serum specimens were gathered for MMP-9 determination with ELISA on admission,at the 5th and 10th day of onset. All patients were scored according to the American National Institutes of Health stroke scale （NIHSS） on admission and recorded Barthal Index（BI） in the 1st and 6 month of onset.Results （1）The serum level of MMP-9 increased after cerebral infarction,and was significantly higher than those in the control group（ P 〈0.05）.There was no significant difference between CE and LAA group （ P 〉0. 05）.MMP-9 in CE and LAA group was significantly higher than those in SA group （ P 〈0.05） .MMP-9 in SA group decreased to normal level while was still higher in CE and LAA group on the 5th day of onset. On the 10th day MMP-9 in all groups decreased to normal.（ 2） There was a positive correlation between MMP-9 within 24 hours of onset and NIHSS（ r =0.883, P 〈0.01）.（3）The serum level of MMP-9 in the cases with better prognosis was significantly lower than those with worse prognosis.Conclusions （1）The serum levels of MMP-9 in all groups increased,but the tendency of their variation was not similar;（2）Serum level of MMP-9 was related to NIHSS, can reflect the severity of the state of cerebral the severity of the state of cerebral infarction;（3）The level of serum MMP-9 within 24 hours of onset can predict prognosis of cerebral infarction independently.

关 键 词：脑梗死 血清基质金属蛋白酶-9(MMP-9) 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]