MMP-9、sCD40L、vWF因子与急性大血管闭塞性脑卒中桥接治疗后出血转化的相关性分析  

Correlation between MMP-9,sCD40L,vWF and hemorrhagic transformation after bridge therapy in patients with acute large vessel occlusive stroke

作　　者：袁波[1] 杜文 刘坤[1] 付舒冉 刘欢 谭莉[1] YUAN Bo;DU Wen;LIU Kun;FU Shuran;LIU Huan;TAN Li(不详;Department of Neurology,Hunan Brain Hospital(The Second People's Hospital of Hunan Province),Changsha Hunan 410000,China)

机构地区：[1]湖南省脑科医院(湖南省第二人民医院)神经内科,410007

出　　处：《中国神经免疫学和神经病学杂志》2023年第6期418-422,共5页Chinese Journal of Neuroimmunology and Neurology

基　　金：湖南省卫生健康委员会资助项目(202103070073)。

摘　　要：目的探讨血清基质金属蛋白酶-9(MMP-9)、血浆可溶性CD40配体(sCD40L)及血管性血友病因子(vWF)与急性大血管闭塞性脑卒中桥接治疗后出血转化的关系。方法选取湖南省脑科医院2021年12月至2022年12月接受桥接治疗的急性大血管闭塞性脑卒中患者90例,根据桥接治疗术中及术后是否出现血管损伤出血等并发症,分为出血转化组和未出血转化组。采用ELISA法检测治疗前和桥接治疗开始后30 min、1 h、2 h、6 h、24 h、5 d,血清MMP-9、sCD40L、vWF因子水平,分析两组间的差异及治疗前后变化。结果治疗前出血转化组和未出血转化组患者血清MMP-9、sCD40L、vWF水平差异无统计学意义(P>0.05)。未出血转化组患者治疗前及治疗后30 min、1 h、2 h、6 h、24 h、5 d,血清中MMP-9、sCD40L、vWF水平均随时间变化未发生统计学变化(P>0.05)。出血转化组血清MMP-9、sCD40L、vWF水平治疗后各时间点均明显高于治疗前(P<0.05),治疗后各时间点MMP-9、sCD40L、vWF水平均随时间变化而升高,且不同时间亚组间比较差异均有统计学意义(均P<0.05);出血转化组患者治疗后各时间点血清MMP-9、sCD40L、vWF水平,除30 min时MMP-9水平差异无统计学意义(P>0.05)外,余均高于未出血转化组相同时间点(P<0.05)。结论桥接治疗后出血转化患者的血清MMP-9、sCD40L和vWF水平增高,且随时间推移逐渐增加。Objective To investigate the correlation between serummatrix metalloproteinase-9(MMP-9),plasma soluble CD40 ligand(sCD40L),vvon Willebrand Factor(vWF)and hemorrhagic transformation after bridge therapy in acute large vessel occlusive stroke.Methods A total of 90 patients with acute large vessel occlusive stroke from Hunan Brain Hospital were included from December 2021 to December 2022.All patients were divided into bleeding conversion group and non-bleeding conversion group,according to whether they had vascular injury and other complications during and after bridge therapy.Serum samples were collected before treatment and 30 min,1 h,2 h,6 h,24 h,and 5 d after the start of bridging treatment,and the levels of serum MMP-9,sCD40L,and vWF factor content were detected by ELISA.The differences between the two groups and the changes before and after treatment were analyzed.Results There were not significant differences in serum MMP-9,sCD40L,and vWF levels between the bleeding conversion group and the non-bleeding conversion group before treatment were not statistically significant(P>0.05).The serum MMP-9,sCD40L,and vWF levels of patients in the non-bleeding conversion group did not change significantly over time at each time before and 30 min,1 h,2 h,6 h,24 h,and 5 d after treatment(P>0.05).Serum MMP-9,sCD40L,and vWF levels in the bleeding conversion group were significantly higher at all time points after treatment than those before treatment(P<0.05).The levels of MMP-9,sCD40L,and vWF in the bleeding conversion group at all time points after treatment increased over time,and the differences between subgroups at different times were statistically significant(P<0.05).The levels of serum MMP-9(except for the 30 min time point),sCD40L,and vWF in the bleeding conversion group were higher than those at the same time points in the non-bleeding conversion group at all time points after treatment(P<0.05).Conclusions Following bridging therapy,the patients with haemorrhagic conversion had increased serum levels of MMP-9,sCD40L

关 键 词：桥接治疗 出血转化 基质金属蛋白酶-9 血浆可溶性CD40配体 血管性血友病因子 

分 类 号：R743.32[医药卫生—神经病学与精神病学]