脑微出血患者血清基质金属蛋白酶-9与出血部位及严重程度的相关性  

Correlation between serum matrix metalloproteinase-9 level and location and severity of bleeding in patients with cerebral microbleeds

作　　者：彭雪 孟利芳 刘昊 王瑾 刘俊丽 贾祥磊[1] 赵盼盼[1] 王凡 王超伟[1] 岳军艳[2] 张健[2] 吉四辈[1] 袁彬[1] 蔡瑞艳[1] 李少敏 赵建华[1] Peng Xue;Meng Lifang;Liu Hao;Wang Jin;Liu Junli;Jia Xianglei;Zhao Panpan;Wang Fan;Wang Chaowei;Yue Junyan;Zhang Jian;Ji Sibei;Yuan Bin;Cai Ruiyan;Li Shaomin;Zhao Jianhua(Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia,Henan Key Laboratory of Neurorestoratology,Department of Neurology,First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000,China;Imaging Department,First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000,China;Ann Romney Center for Neurologic Diseases,Brigham and Women’s Hospital,Harvard Medical School,Boston,Massachusetts 02115,United States)

机构地区：[1]新乡医学院第一附属医院神经内科,河南省神经修复重点实验室,河南省老年性痴呆神经修复国际联合实验室,453000 [2]新乡医学院第一附属医院影像科,453000 [3]美国哈佛大学医学院布莱根妇女医院神经疾病研究中心,波士顿02115

出　　处：《中华行为医学与脑科学杂志》2021年第3期244-249,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：河南省自然科学基金项目 (182300410389);河南省医学科技攻关计划联合共建项目 (LHGJ20190436)。

摘　　要：目的探讨血清基质金属蛋白酶-9(matrix metalloproteinases-9,MMP-9)水平与脑微出血(cerebral microbleeds,CMBs)部位及严重程度的相关性。方法2019年1月至2020年8月经新乡医学院第一附属医院神经内科收治并予以头颅MRI检测有CMBs患者60例作为CMBs组,以同期门诊体检无神经系统疾病的健康者60例作为对照组,收集两组一般临床资料,生化指标,酶联免疫吸附法检测血清MMP-9的水平,并根据磁敏感加权成像(susceptibility-weighted imaging,SWI)将CMBs数量分为1级(n=24),2级(n=19),3级(n=17),根据脑微出血解剖评分量表(microbleed anatomical rating scale,MARS)将CMBs部位分为脑叶组(n=19)、深部或幕下组(n=17)和混合组(n=24),分析血清MMP-9水平与CMBs部位及其严重程度的关系。使用SPSS 19.0软件进行统计方差分析、t检验、秩和检验进行组间比较,影响因素分析采用Logistic回归分析,相关分析采用Pearson相关分析和Spearman相关分析。结果CMBs组MMP-9水平明显高于对照组[208.13(142.25,285.88)μg/L,149.50(93.40,186.51)μg/L],差异有统计学意义(P<0.05)。MMP-9水平是CMBs的危险因素(β=1.322,OR=3.750,95%CI=2.038~7.997,P=0.002)。不同严重程度CMBs患者MMP-9水平差异有统计学意义[147.55(109.25,266.47)μg/L,242.12(147.55,288.80)μg/L,270.42(203.43,364.27)μg/L,P=0.017]。MMP-9水平与CMBs个数呈正相关(r=0.371,P=0.003)。不同出血部位CMBs的MMP-9水平差异有统计学意义[249.77(158.43,338.46)μg/L,188.83(138.52,243.15)μg/L,210.65(144.25,255.78)μg/L](P=0.013),MMP-9水平是脑叶CMBs的危险因素(β=0.401,OR=1.122,95%CI=1.004~1.204,P=0.036)。结论血清MMP-9水平升高可能是CMBs的危险因素,尤其是脑叶CMBs,且MMP-9水平与脑微出血严重程度呈正相关。Objective To investigate the relationship between serum matrix metalloproteinase-9(MMP-9)level and the location and severity of bleeding in patients with cerebral microbleeds(CMBs).Methods A total of 60 CMBs patients admitted to the Department of Neurology of the First Affiliated Hospital of the Xinxiang Medical University from January 2019 to August 2020 were selected as subjects as the CMBs group,and 60 healthy controls without nervous system diseases in outpatient physical examination during the same period were selected as the control group.The clinical data and biochemical indicators of the two groups were collected.Serum MMP-9 levels were measured by enzyme linked immunosorbent assay(ELISA).According to susceptibility weighted imaging(SWI),CMBs patients were divided into grade 1 group(n=24),grade 2 group(n=19)and grade 3 group(n=17),and according to the micro analytical rating scale(MARS),the CMBs patients were divided into the lobar group(n=19),the deep or infratentorial group(n=17)and the mixed group(n=24).The relationship between serum MMP-9 level and the location and severity of CMBs was analyzed.SPSS 19.0 software was used for data statistical analysis.One-way ANOVA,t-test and rank sum test were used for comparison.Logistic regression analysis was used to analyze the influencing factors.Pearson correlation analysis and Spearman correlation analysis were used for correlation analysis.Results The level of MMP-9 in CMBs group was significantly higher than that in control group(208.13(142.25,285.88)μg/L,149.50(93.40,186.51)μg/L),and the difference was statistically significant(P<0.05).Serum MMP-9 level was a risk factor of CMBs(β=1.322,OR=3.750,95%CI=2.038-7.997,P=0.002).The difference of level of MMP-9 in different severity of CMBs was statistically significant(147.55(109.25,266.47)μg/L,242.12(147.55,288.80)μg/L,270.42(203.43,364.27)μg/L,P=0.017).Serum MMP-9 level was positively correlated with the number of CMBs(r=0.371,P=0.003).The difference of MMP-9 level of CMBs in different locations were stat

关 键 词：脑微出血 基质金属蛋白酶-9 磁敏感加权成像 

分 类 号：R743.34[医药卫生—神经病学与精神病学]