血清碱性髓鞘蛋白、D-二聚体、基质金属蛋白酶-9与患者不同分型急性脑梗死的关系研究  

Relationship between serum MBP,D-dimer,MMP-9 and different types of acute cerebral infarction

作　　者：王小燕 赵丽霞[2] 高钟生 李海云 何文静 王丽敏 WANG Xiaoyan;ZHAO Lixia;GAO Zhongsheng;LI Haiyun;HE Wenjing;WANG Limin(Department of Neurology,Zhangjiakou First Hospital,Zhangjiakou 075000,China)

机构地区：[1]张家口市第一医院神经内科,河北张家口075000 [2]河北北方学院附属第一医院肿瘤内科,河北张家口075000

出　　处：《陕西医学杂志》2024年第10期1407-1411,共5页Shaanxi Medical Journal

基　　金：河北省卫生健康委员会医学科学研究课题(20220608);河北省张家口市重点研发计划项目(2121107D)。

摘　　要：目的:探讨分析血清碱性髓鞘蛋白(MBP)、基质金属蛋白酶-9(MMP-9)、D-二聚体(D-D)与患者不同分型急性脑梗死(ACI)的关系。方法:选取74例恶性肿瘤合并ACI患者作为观察组,另选取同期住院的单纯恶性肿瘤患者47例作为对照组,比较两组MBP、D-D、MMP-9水平及临床基本资料。根据TOAST将观察组患者分为大动脉粥样硬化(LAA)型、小动脉闭塞(SAO)型、心源性栓塞(CE)型、其他病因(OC)型、隐源(UND)型,比较不同分型患者血清D-D、MBP、MMP-9水平;分析MBP、D-D、MMP-9与恶性肿瘤合并ACI的关系。结果:观察组MBP、D-D、MMP-9、纤维蛋白原、低密度脂蛋白胆固醇(LDL-C)、水平合并吸烟史、高血压史所占比例均高于对照组,高密度脂蛋白胆固醇(HDL-C)水平低于对照组(均P<0.05);LAA组MBP及MMP-9在所有分型中水平最高;D-D水平高于SAO、OC、UND组(均P<0.05);CE组D-D在所有分型中水平最高,MBP及MMP-9水平明显高于SAO、OC、UND组(均P<0.05);SAO组MBP水平显著低于OC、UND组,MMP-9水平显著高于OC、UND组,D-D水平显著高于UND组(均P<0.05);OC组MBP及D-D水平显著高于UND组,MMP-9水平低于UND组,差异有统计学意义(均P<0.05);MBP、D-D、MMP-9合并LDH、纤维蛋白原及高血压史均是影响恶性肿瘤患者发生ACI的独立危险因素(均P<0.05);MBP、D-D、MMP-9联合诊断恶性肿瘤患者发生ACI的曲线下面积为0.920,高于单项检测(均P<0.05)。结论:血清MBP、D-D、MMP-9水平在恶性肿瘤合并ACI患者中明显升高,且与TOAST分型密切相关,三者均是影响恶性肿瘤发生ACI的独立危险因素,联合检测作为临床早期诊断有效方法。Objective:To investigate the relationship between serum basic myelin protein(MBP),matrix metalloproteinase-9(MMP-9),D-dimer(D-D)and different types of acute cerebral infarction(ACI).Methods:A total of 74 patients with malignant tumors combined with ACI were selected as the observation group,and 47 patients with simple malignant tumors during the same period were selected as the control group.The levels of MBP,D-D,MMP-9 and basic clinical data of the two groups were compared.According to TOAST,patients in the observation group were divided into large atherosclerosis(LAA)type,small artery occlusion(SAO)type,cardiac embolism(CE)type,other etiology(OC)type,and implicit origin(UND)type.Serum D-D,MBP,MMP-9 levels of patients in different types were compared.The relationship between MBP,D-D,MMP-9 and ACI in malignant tumors were analyzed.Results:The proportions of MBP,D-D,MMP-9,fibrinogen,low density lipoprotein cholesterol(LDL-C)level,smoking history and history of hypertension in observation group were higher than those in control group,and the level of high density lipoprotein cholesterol(HDL-C)was lower than that in control group(all P<0.05).The levels of MBP and MMP-9 in LAA group were the highest among all types.The level of D-D was higher than that of SAO,OC and UND groups(all P<0.05).The level of D-D in CE group was the highest among all types,and the levels of MBP and MMP-9 were significantly higher than those in SAO,OC and UND groups(all P<0.05).MBP level in SAO group was significantly lower than that in OC and UND groups,MMP-9 level was significantly higher than that in OC and UND groups,and D-D level was significantly higher than that in UND group(all P<0.05).MBP and D-D levels in OC group were significantly higher than those in UND group,and MMP-9 levels were lower than those in UND group(all P<0.05).MBP,D-D,MMP-9 combined with LDH,fibrinogen and history of hypertension were independent risk factors for ACI in patients with malignant tumors(all P<0.05).The area under the curve of ACI in patients diagnosed w

关 键 词：急性脑梗死 TOAST分型 D-二聚体 血清碱性髓鞘蛋白 基质金属蛋白酶-9 恶性肿瘤 

分 类 号：R743[医药卫生—神经病学与精神病学]