急性老年缺血性脑卒中患者溶栓前后MMP-9、miR-139水平变化及临床意义  

Changes in serum mmp-9 and mir-139 levels before and after thrombolysis in acute elderly ischemic stroke patients and their clinical significance

作　　者：何育教 李鹏翔[2] 谢荣香 HE Yujiao;LI Pengxiang;XIE Rongxiang(Chengmai Branch of the Second Affiliated Hospital of Hainan Medical College,Haikou Hainan 571900,China)

机构地区：[1]海南医学院第二附属医院澄迈分院,海南海口571900 [2]海南医学院第二附属医院,海南海口570216

出　　处：《中国急救复苏与灾害医学杂志》2024年第12期1588-1591,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：海南省卫生健康行业科研项目(编号:21A200391)。

摘　　要：目的探讨急性老年缺血性脑卒中患者溶栓前后MMP-9和miR-139水平变化以及对患者预后的预测价值。方法选取2022年6月—2023年6月在海南医学院第二附属医院收治住院的110例急性老年缺血性脑卒中患者为研究对象(研究组),另选取同期60例健康体检者作为对照组。收集各组临床资料,根据随访期间mRS评分划分成预后不良组和预后良好组。检测溶栓前后血清MMP-9和miR-139水平变化,比较各组患者临床资料以及MMP-9和miR-139水平差异,通过Logistic回归分析预后不良的危险因素。使用受试者工作特征(ROC)曲线分析各指标单独及联合对溶栓后预后不良的预测价值。结果急性老年缺血性脑卒中组患者血清MMP-9和miR-139水平显著高于对照组(t=24.390、11.740,均P<0.001);与治疗前比较,治疗24 h、3 d后二者水平显著降低(均P<0.001);预后不良组溶栓前血清MMP-9和miR-139水平、溶栓前NIHSS评分、发病至溶栓时间均高于预后良好组(t=12.450、2.293、5.861、2.344,均P<0.05);Logistic分析表明,溶栓前miR-139和血清MMP-9水平是患者预后不良的独立危险因素(均P<0.05)。二者联合检测预测预后不良的AUC为0.913,敏感性和特异性分别为0.896和0.922。结论急性缺血性脑卒中患者血清MMP-9和miR-139水平较高,溶栓后二者水平降低;溶栓前血清MMP-9和miR-139水平是影响预后的独立危险因素;两者联合检测对急性缺血性脑卒中溶栓后预后不良具有较高的预测价值。Objective To investigate the changes in levels of MMP-9 and miR-139 before and after thrombolysis in elderly patients with acute ischemic stroke and their predictive value for patient outcomes.Methods 110 acute elderly ischemic stroke patients admitted to our hospital from June 2022 to June 2023 were chose as the study subjects(the research group),and 60 healthy individuals who underwent physical examinations during the same period were selected as the control group.Collect clinical data from each group and divide patients into a good prognosis group and a poor prognosis group based on the mRS score during the follow-up period.Detect changes in serum MMP-9 and miR-124 before and after thrombolysis,and compare clinical data and differences in serum MMP-9 levels among different groups of patients.Logistic regression analysis was used to determine the risk factors for adverse prognosis.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of individual and combined indicators for adverse prognosis after thrombolysis.Results The serum MMP-9 and miR-124 levels in patients with acute stroke were significantly increased(t=24.390,11.740,all P<0.001),Compared with before treatment,the serum MMP-9 and miR-124 levels significantly decreased after 24 hours and 3 days of treatment(all P<0.001),The serum MMP-9 and miR-124 levels before thrombolysis,NIHSS scores before thrombolysis,and time from onset to thrombolysis in patients with poor prognosis were higher than those in patients with good prognosis(t=12.450,2.293,5.861,2.344,all P<0.05),Logistic multivariate analysis showed that pre thrombolytic serum MMP-9 and miR 124 levels were independent risk factors for poor prognosis in patients(both P<0.05).The AUC for predicting poor prognosis after thrombolysis in acute stroke patients with combined detection of serum MMP-9 and miR-139 levels was 0.913,with sensitivity and specificity of 0.896 and 0.922,respectively.Conclusion Patients with acute ischemic stroke have higher levels of s

关 键 词：急性老年缺血性脑卒中 溶栓 MMP-9 miR-139 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]