急性缺血性脑卒中患者血清MMP-9及TIMP-1的变化及其临床意义  

The change and clinic significance of MMP-9 and TIMP-1 in acute ischemic stroke

作　　者：岳蕴华[1] 白旭东 张小宁[1] 马建华[1] 毛洁萍 曾海波 地拉娜木 米合热依 

机构地区：[1]新疆医科大学第一附属医院神经内科,新疆乌鲁木齐830054 [2]乌鲁木齐市友谊医院心内科,新疆乌鲁木齐830049 [3]乌鲁木齐市友谊医院神经内科,新疆乌鲁木齐830049

出　　处：《中风与神经疾病杂志》2013年第11期1008-1011,共4页Journal of Apoplexy and Nervous Diseases

基　　金：国家自然科学基金项目(81160145);乌鲁木齐市科学技术计划项目(Y101310009)

摘　　要：目的探讨急性缺血性脑卒中(AIS)患者血清基质金属蛋白酶-9(MMP-9)、组织基质金属蛋白酶抑制物(TIMP-1)水平的变化及其与病情预后的关系。方法选择AIS患者280例,按临床神经功能缺损程度评分标准,进行病情程度及预后进行分组。分别测定发病后24h内、3d、14d、28d血清MMP-9、TIMP-1浓度。另设健康体检者164例为对照组。结果 (1)AIS组不同时期血清MMP-9、TIMP-1水平及MMP-9/TIMP-1比值组间有差异(P均<0.01)。AIS患者血清MMP-9、TIMP-1及MM P-9/TIMP-1(377.58±32.77)ng/ml、(302.29±42.25)ng/ml及(1.25±0.17)均明显高于对照组(67.38±10.46)ng/ml、(100.68±34.21)ng/ml及(0.67±0.11)(P<均0.01)。(2)发病24h内轻、中、重型AIS患者血清MMP-9、TIMP-1水平及MMP-9/TIMP-1比值差异有统计学意义(P<0.05或P<0.01)。(3)发病28d不同预后组的AIS患者血清MMP-9、TIMP-1水平、MMP-9/TIMP比值组间差异有统计学意义(P均<0.05),基本治愈组和显著进步组较无变化组的血清MMP-9、TIMP-1水平明显减少(P均<0.01)。(4)AIS组MMP-9水平与高敏C反应蛋白(hs-CRP)、血糖、低密度脂蛋白胆固醇(LDL-C)水平呈直线正相关。结论血清MMP-9、TIMP-1水平改变和MMP-9/TIMP-1比值的失衡可作为临床评价AIS严重程度和预后的重要生物学指标。Abstract： Objective To study the change of serum matrix metalloproteinase 9 （MMP-9） and tissue inhibitor of ma- trix metalloproteinase 1 （TIMP-1）in acute ischemic stroke patients（ AIS）, and analyse the relationship with disease progno- sis. Methods 226 AIS patients were enrolled in the investigation. Based on the MESS,patients were divided into differ- ent groups according to the levels of severity and prognosis. And 164 physically healthy subjects were selected as controls. The concentration of serum MMP-9 ,TIMP-1 ,and MMP-9/TIMP-1 were determined in all cases after being attacked within 24 hour,day3 ,dayl4 and day28 respectively. Results （I） Serum contents of MMP-9, TIMP-I, and MMP-9/TIMP-I in AIS in different stages had significant difference. Serum contents of MMP-9 ,TIMP-1, and MMP-9/TIMP-1 in AIS were re- markably higher than controls [ （ 377.58 ± 32.77） ng,/ml, （ 302.29 ± 42.25 ） ng/ml, （ 1.25 ± 0.17 ） and （ 67.38± 10.46 ） ng/ml, （ 100.68± 34.21 ）ng/ml, （0.67± 0.11 ） ,P 〈 0.01 ]. （2） Serum contents of MMP-9, TIMP-1, and M MP-9/TIMP- 1 among the light, medium and heavy cases after being attacked in 24hour had significant difference. （3） Serum contents of MMP-9 ,TIMP-1 ,and MMP-9/TIMP-1 in basically curable cases and remarkably improved cases after being attacked in day28 were remarkably lower than unchanged ones. （4） The levels of hs-CRP,glucose and LDL-C were correlated with the levels of MMP-9 in AIS. Conclusions The change of serum MMP-9 ,TIMP-1 and imbalance of MMP-9/TIMP-1 are signif- icant bioindicators to evaluate the level of severity and prognosis of AIS.

关 键 词：急性缺血性脑卒中 基质金属蛋白酶-9 组织基质金属蛋白酶抑制物-1 

分 类 号：R743.3[医药卫生—神经病学与精神病学]