外周血ET-1、MMP-9、RDW-CV与急性脑梗死病情的关系及对预后的预测价值  

Relationship between ET-1,MMP-9,RDW-CV and acute cerebral infarction and their prognostic value

作　　者：袁治玲 苏洲[1] 袁燕[1] 周艳霞[1] YUAN Zhiling;SU Zhou;YUAN Yan;ZHOU Yanxia(Department of Geriatrics,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang,Henan,China,453100)

机构地区：[1]新乡医学院第一附属医院神经内科一病区老年病科,河南新乡453100

出　　处：《分子诊断与治疗杂志》2022年第1期124-128,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划项目(2018091135)。

摘　　要：目的探讨外周血内皮素-1(ET-1)、基质金属蛋白酶-9(MMP-9)、红细胞分布宽度变异系数(RDW-CV)与急性脑梗死病情的关系及对预后的预测价值。方法选择2020年3月至2020年11月新乡医学院第一附属医院166例中重型急性脑梗死患者作为病例组研究对象,根据神经功能缺损评分(NIHSS评分)分为轻型组(NIHSS评分≤16分)118例、重型组(NIHSS评分>16分)48例;同期选择100例健康体检人群作为对照组。采用酶联免疫吸附法(ELISA)检测ET-1、MMP-9、RDW-CV水平。Spearman相关分析不同梗死面积及NIHSS评分患者与上述指标的相关性。随访3月,病例组患者根据改良Rankin量表(mRS评分)分为预后良好组(mRS<2分)与预后不良组(mRS≥2分)。结果三组间ET-1、MMP-9、RDW-CV比较:重型组>轻型组>对照组,差异有统计学意义(P<0.05)。NIHSS评分及脑梗死面积与ET-1、MMP-9、RDW-CV之间存在正相关关系(P<0.05)。预后不良组静脉溶栓、机械取栓、腔隙性梗死的比例低于预后良好组差异有统计学意义(P<0.05);年龄≥60岁、糖尿病、高血压、NIHSS评分>16分、脑干梗死、大面积脑梗死比例高于预后良好组,差异有统计学意义(P<0.05)。预后良好组ET-1、MMP-9、RDW-CV水平均低于预后不良组,差异有统计学意义(P<0.05)。多因素Logistic回归分析,结果显示年龄≥60岁、静脉溶栓、NIHSS评分>16分、脑干梗死、大面积脑梗死、ET-1≥2.78 pg/mL、MMP-9≥43.11 ng/L、RDW-CV≥14.99%的急性脑梗死患者预后不良的可能性大。结论外周血ET-1、MMP-9、RDW-CV与急性脑梗死严重程度及脑梗死面积大小呈正相关关系,ET-1、MMP-9、RDW-CV联合预测脑梗死预后有较高的价值。Objective To investigate the relationship between endothelin-1(ET-1),matrix metalloproteinase-9(MMP-9)and red blood cell distribution width coefficient of variation(RDW-CV)in peripheral blood and acute cerebral infarction and their prognostic value.Methods A total of 166 patients with moderate and severe acute cerebral infarction were selected as the case group.According to the neurological deficit score(NIHSS score),they were divided into a mild group(NIHSS score≤16)in 118 cases and a severe group(NIHSS score>16)in 48 cases.In the same period,100 healthy people were selected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to test endothelin-1(ET-1),matrix metalloproteinase-9(MMP-9)and red blood cell distribution width coefficient of variation(RDW-CV)levels in peripheral blood of all subjects.The differences between the different subjects were compared,and the Spearman correlation was used to analyze the correlation between patients with different infarct size and NIHSS score and the above indicators.After a follow-up of three months,the patients in the case group were divided into a good prognosis group(mRS<2 points)and a bad prognosis group(2 points≤mRS)according to the modified Rankin scale(MRS score).Results The comparison of ET-1,MMP-9 and RDW-CV among the three groups showed that the severe group>the mild group>the control group,and the differences were statistically significant(P<0.05).There was a positive correlation between the NIHSS score and cerebral infarct size and ET-1,MMP-9,RDW-CV(P<0.05).The proportions of intravenous thrombolysis,mechanical thrombectomy and lacunar infarction in the poor prognosis group were lower than that in the good prognosis group(P<0.05).The proportion of patients with age≥60 years old,diabetes,hypertension,NIHSS score>16,brainstem infarction and massive cerebral infarction was higher than that in the good prognosis group(P<0.05).The levels of ET-1,MMP-9 and RDW-CV in the good prognosis group were lower than those in the bad prognosis group,and th

关 键 词：内皮素-1 基质金属蛋白酶-9 红细胞分布宽度变异系数 急性脑梗死 

分 类 号：R743.33[医药卫生—神经病学与精神病学]