急性脑梗死合并2型糖尿病患者微栓子与血清基质金属蛋白酶-9的关系  

Relationship between serum matrix metalloproteinase-9 activity and microemboli in patients of acute cerebral infarction with type 2 diabetes

作　　者：王洪海[1] 钟池[1] 胡鸣一[1] 万德坤 牟小华[1] 

机构地区：[1]潍坊医学院附属潍坊市人民医院神经内科,山东省261041

出　　处：《中华临床医师杂志（电子版）》2014年第8期41-45,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨急性脑梗死合并2型糖尿病患者脑动脉微栓子与血清基质金属蛋白酶-9含量的关系。方法前瞻性地纳入颈动脉系统急性脑梗死患者118例,分为糖尿病急性脑梗死组60例、非糖尿病急性脑梗死组58例。收集一般临床资料,采用EMS-9型经颅多普勒超声检测仪及酶联免疫吸附测定法(ELISA)分别检测所有入组患者大脑中动脉微栓子信号及血清基质金属蛋白酶-9浓度,并进行相关分析。结果糖尿病并急性脑梗死患者微栓子信号阳性率高于非糖尿病急性脑梗死患者(P<0.05);糖尿病并急性脑梗死患者的血清基质金属蛋白酶-9含量明显高于非糖尿病急性脑梗死患者(P<0.01);Logistic回归提示,血清基质金属蛋白酶-9是微栓子信号阳性的危险因素(OR=1.013,P<0.01)。结论糖尿病并急性脑梗死患者微栓子信号阳性率与血清基质金属蛋白酶-9含量更高,基质金属蛋白酶-9的高表达可能促进微栓子的产生。Objective To investigate the relationship between serum matrix metalloproteinase-9 （MMP-9） levels and transcranial Doppler （TCD）-detected microemboli in patients of acute cerebral infarction patients with type 2 diabetes. Methods The qualified 118 cases of acute cerebral infarction of carotid artery system in the study were included, 60 cases of acute cerebral infarction with type 2 diabetes and 58 cases of acute cerebral infarction with non diabetes-mellitus. General clinical data were collected. The serum MMP-9 levels were quantified by ELISA and the microemboli signal（MES）were detected with TCD in the 2 groups, and statistical analysis and statistical comparisons were done. Results The micro-emboli positive rate was higher in acute cerebral infarction patients with type 2 diabetes than that in acute cerebral infarction ones with non diabetes-mellitus（P〈0.05）; The level of serum MMP-9 was significantly higher in acute cerebral infarction patients with type 2 diabetes than that in cerebral infarction ones with non diabetes-mellitus（P〈0.01）;Logistic regression analysis showed that MMP-9 level was a risk factor of MES（OR=1.013, P〈0.01） in acute cerebral infarction patients. Conclusion The micro-emboli positive rate and the level of serum MMP-9 are higher in patients of acute cerebral infarction with type 2 diabetics, the rise of serum MMP-9 level can result in microemboli.

关 键 词：糖尿病 2型 脑梗死 基质金属蛋白酶9 超声检查 多普勒 经颅 栓塞 DIABETES mellitus type 2 Matrix METALLOPROTEINASE 9 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R587.1[医药卫生—临床医学]