脑脊液基质金属蛋白酶-9、白细胞介素-10表达与蛛网膜下腔出血后脑血管痉挛及预后的相关性研究  

Correlation between the expression of MMP-9 and IL-10 in cerebrospinal fluid and cerebral vasospasm and prognosis after subarachnoid hemorrhage

作　　者：彭宪星 王远波 孙启朋 PENG Xianxing;WANG Yuanbo;SUN Qipeng(Department of Neurology,Ward 1,Central Hospital of Zaozhuang Mining Group,Zaozhuang,Shandong 277000,China)

机构地区：[1]枣庄矿业集团中心医院神经内科一病区,山东枣庄277000

出　　处：《安徽医药》2025年第3期615-619,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨脑脊液基质金属蛋白酶-9(MMP-9)、白细胞介素-10(IL-10)与蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)及预后的相关性。方法选取2019年1月至2021年3月枣庄矿业集团中心医院收治的201例SAH病人作为研究对象,根据是否发生CVS将所有病人分为非CVS组(92例),CVS组(109例);根据CVS病人随访90 d后改良Rankin量表(mRS)评分将所有病人分为预后良好组(0~2分,66例)和预后不良组(3~6分,43例)。采用酶联免疫吸附测定(ELISA)法检测所有病人脑脊液MMP-9、IL-10的表达水平;Pearson法分析CVS病人脑脊液MMP-9与IL-10表达水平的相关性;使用受试者操作特征曲线(ROC曲线)分析MMP-9、IL-10对CVS病人预后不良的预测价值;采用多因素logistic回归分析影响CVS病人预后不良的危险因素。结果入院1、7、14 d时,非CVS组病人脑脊液MMP-9[(304.64±41.56)μg/L、(325.88±47.12)μg/L、(391.09±56.29)μg/L]表达水平和CVS组[(438.77±60.90)μg/L、(461.92±58.43)μg/L、(532.74±63.00)μg/L]依次升高(P<0.05),非CVS组脑脊液IL-10[(513.27±60.23)ng/L、(471.05±51.92)ng/L、(442.89±45.58)ng/L]表达水平和CVS组[(409.62±49.29)ng/L、(380.26±40.75)ng/L、(351.66±43.21)ng/L]依次降低(P<0.05);与非CVS组比较,CVS组病人各时间点脑脊液MMP-9表达水平均显著升高(P<0.05),IL-10表达水平均显著降低(P<0.05)。预后不良组病人脑脊液MMP-9[(621.12±85.85)μg/L、(319.97±44.64)μg/L]表达水平、Hunt-Hess分级、改良Fisher分级、脑积水程度、格拉斯哥昏迷(GCS)评分显著高于预后良好组病人,而预后不良组病人脑脊液IL-10[(346.93±39.56)ng/L、(450.46±55.63)ng/L]表达水平低于预后良好组病人(P<0.05)。CVS病人脑脊液MMP-9与IL-10表达水平呈负相关(r=-0.57,P<0.05)。ROC曲线分析显示,脑脊液MMP-9、IL-10、二者联合预测CVS病人预后不良的曲线下面积(AUC)分别为0.84、0.81、0.93,二者联合的AUC明显高于脑脊液MMP-9、IL-10单独预测(P<0.05);多因素logistic回Objective To investigate the correlation between cerebrospinal fluid matrix metalloproteinase-9(MMP-9),interleukin-10(IL-10)and cerebral vasospasm(CVS)and prognosis after subarachnoid hemorrhage(SAH).Methods A total of 201 SAH patients admitted to Zaozhuang Mining Group Central Hospital from January 2019 to March 2021 were selected as the research objects.According to whether CVS occurred,all patients were divided into non-CVS group(92 cases)and CVS group(109 cases);according to the modified Rankin scale(mRS)score of CVS patients after 90 days of follow-up,all patients were divided into good prognosis group(0-2 points,66 cases)and poor prognosis group(3-6 points,43 cases).Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression levels of MMP-9 and IL-10 in the cerebrospinal fluid of all patients;Pearson method was used to analyze the correlation between the expression levels of MMP-9 and IL-10 in cerebrospinal fluid of patients with CVS;ROC curve was used to analyze the predictive value of MMP-9 and IL-10 for poor prognosis of CVS patients;multivariate Logistic regression analysis was used to analyze the risk factors affecting the poor prognosis of CVS patients.Results At 1,7 and 14 days after admission,the expression level of MMP-9 in cerebrospinal fluid of patients in non-CVS group[(304.64±41.56)μg/L,(325.88±47.12)μg/L,(391.09±56.29)μg/L]and CVS group[(438.77±60.90)μg/L,(461.92±58.43)μg/L,(532.74±63.00)μg/L]increased successively(P<0.05),and the expression level of IL-10 in cerebrospinal fluid of patients in the non-CVS group[(513.27±60.23)ng/L,(471.05±51.92)ng/L,(442.89±45.58)ng/L]and the CVS group[(409.62±49.29)ng/L,(380.26±40.75)ng/L,(351.66±43.21)ng/L]decreased successively(P<0.05);compared with the non-CVS group,the expression level of MMP-9 in the cerebrospinal fluid of the CVS group was significantly increased(P<0.05),and the expression level of IL-10 was significantly decreased(P<0.05).The expression level of MMP-9[(621.12±85.85)μg/L,(319.97±44.64)μg/L],Hunt-Hess c

关 键 词：蛛网膜下腔出血 脑血管痉挛 基质金属蛋白酶-9 白细胞介素-10 预后 

分 类 号：R743.35[医药卫生—神经病学与精神病学]