基质金属蛋白酶家族在颅脑损伤患者中表达水平的变化  

Matrix metalloproteinases and their tissueinhibitors in serum and cerebrospinal fluid of patients with traumatic brain injury

作　　者：郑克彬[1] 刘艳峰[1] 刘海鹏[1] 单小松[1] 郭毅[1] 李春晖[1] 李志红[1] 

机构地区：[1]河北大学附属医院神经外科,河北保定071000

出　　处：《中华实验外科杂志》2015年第1期178-179,共2页Chinese Journal of Experimental Surgery

基　　金：河北省自然科学基金资助项目（2013201283）;河北大学医学学科专项资金资助项目（201282004）

摘　　要：目的 探讨颅脑损伤（TBI）患者基质金属蛋白酶（MMPs）和基质金属蛋白酶抑制剂（TIMPs）水平之间的关系以及与临床预后的相关性.方法 收集颅脑损伤患者30例,并分为轻重两组,分别留取24、72、120 h内脑脊液及静脉血,10例健康体检者为对照组,用双抗体夹心酶联免疫吸附试验（ELISA）法检测MMPs和TIMPs水平.结果 本实验检测到MMP-9在颅脑损伤患者组脑脊液中24 h内达到高峰[（71.34±13.93） μg/L],可以持续72 h.TIMP-1在120 h内可达高峰[（162.24±17.15） μg/L],相对第72小时及第24小时内差异有统计学意义（P＜0.05）.颅脑损伤患者与对照组的MMP-9、MMP-2、TIMP-1及TIMP-2无论脑脊液还是血液中的表达差异均有统计学意义（P＜0.05）.重度TBI患者组的MMP-9在脑脊液水平显著高于轻度TBI患者组.颅脑损伤患者组伤后MMP-9 （24 h）含量与TIMP-1（120 h）含量呈正相关（P＜0.01）.结论 MMPs和TIMPs在颅脑损伤患者脑脊液和血浆中增加,TIMP-1和MMP-9呈正相关,MMP-9可以作为预测颅脑损伤患者临床预后的指标.Objective In this study,we investigated matrix metalloproteinases （MMPs） and tissue inhibitor of metalloproteinase （TIMPs） in cerebrospinal fluid （CSF） and plasma of traumatic brain injury （TBI） patients.Methods A total of 30 patients with moderate and severe TBI and 15 age-matched controls were enrolled in this study.Plasma and CSF samples were collected within 24 h （as the initial value）,at 72 and 120 h post injury.CSF and plasma MMP-9,MMP-2,TIMP-1 and TIMP-2 were estimated using enzyme linked immunosorbent assay （ELISA）.Different levels of these indexes were compared in the two groups and further investigated the correlation between each other.Results There was a significant elevation in the levels of the initial MMP-9 in the CSF [（71.34 ± 13.93） μg/L],which lasted for 72 h post injury.TIMP-1 kept increasing within 120 h post injury[（162.24 ±17.15） μg/L] and it was different compared with TIMP-1 at 24 and 72 h post injury.Plasma levels of MMP-9,MMP-2,TIMP-1 and TIMP-2 in TBI patients were also significantly different from those in controls.Furthermore the CSF MMP-9 in patients with severe TBI was higher than that in patients with moderate TBI.In addition,there was a positive relationship between the initial MMP-9 and TIMP-1 at 120 h post injury （r =0.614,P 〈0.01）.Conclusion MMPs and TIMPs are increased in both CSF and plasma of TBI patients.TIMP-1 has a positive correlation with MMP-9 and the initial MMP-9 is associated with the neurological outcomes.

关 键 词：颅脑损伤 基质金属蛋白酶 基质金属蛋白酶抑制剂 脑脊液 

分 类 号：R651.15[医药卫生—外科学]