不同TOAST分型脑梗死患者血清基质金属蛋白酶-3水平的研究  

Research on level of serum matrix mataloproteinase-3 in cerebral infarction patients with differentTOAST classifications

作　　者：吴健[1] 陈应柱[1] 俞龙[1] 

机构地区：[1]江苏省苏北人民医院神经内科,江苏扬州225001

出　　处：《实用临床医药杂志》2012年第24期20-22,共3页Journal of Clinical Medicine in Practice

基　　金：江苏省扬州市社会发展计划项目(Wb20052021)

摘　　要：目的探讨血清基质金属蛋白酶(MMP)-3和急性脑梗死(CI)TOAST分型和预后的关系。方法应用ELISA法检测82例CI患者(CI组)和32例对照者(NC组)血清MMP-3,根据TOAST分型,CI组又分为小动脉闭塞型34例、大动脉粥样硬化性型(15例)、心源性栓塞型10例、其他明确病因型1例、不明原因型22例,比较各组血清MMP-3水平的变化。结果 CI组患者脑梗死后第1天血清MMP-3水平较NC组明显升高,差异有统计学意义(P<0.01),心源性脑栓塞组和大动脉粥样硬化性脑梗死组患者脑梗死后第1天血清MMP-3明显高于腔隙性脑梗死组,差异均有统计学意义(P<0.01),进展性脑梗死发病1、3、7 d内血清MMP-3水平明显高于非进展性脑梗死,差异有统计学意义(P<0.01)。结论急性脑梗死患者血清MMP-3水平增高,TOAST各亚型患者组MMP-3水平变化不同,大动脉粥样硬化性型(LAA型)组升高最显著,支持脑梗死亚型的病因不同的论点,血清MMP-3在LAA型脑梗死发病过程中起着重要作用。Objective To explore the relationship among levels of serum matrix metallopro- teinase-3 （MMP-3） , cerebral infarction of different TOAST classifications and the prognosis in pa- tients with acute cerebral infarction （CI）. Methods The levels of MMP-3 were detected by ELISA, which contained 82 cerebral infarction patients（CI group） and 32 healthful donors （NC group）. According to TOAST classifications, CI group was composed of 34 cases of small artery oc- clusion, 15 cases of aorta atherosclerosis, 10 cases of cardiac embolism, 1 case of definite pathogen and 22 eases of unknown pathogens. Levels of MMP-3 were compared between groups. Results The level of MMP-3 in CI group was significantly higher than NC group in the first day after onset of CI （P〈0.01）. The first after CI, the levels of MMP-3 in cardiac embolism group and large artery arteriosclerosis group （LAA group） were significantly higher than lacunar infarction group （P 〈 0.01）. The level of serum MMP-3 in nonprogressed C1 patients was significantly lower than pro- gressed CI ion patients （P 〈 0.01 ）. Conclusion The serum MMP-3 Levels increase in patients with acute cerebral infarction. The changes of the serum MMP-3 levels in each TOAST subtype group are different. The LAA group increases significantly, which support the different views of the etiol- ogy of cerebral infarction subtypes. The serum MMP-3 plays an important role in the onset of cere- bral infarction of the LAA type.

关 键 词：脑梗死 基质金属蛋白酶3 急性卒中治疗低分子肝素试验(TOAST) 

分 类 号：R743.33[医药卫生—神经病学与精神病学]