血清基质金属蛋白酶-9——脑梗死预后的潜在临床标志物  

Serum Matrix Metalloproteinase-9: a Potential Clinical Marker for Prognosis of Cerebral Infarction

作　　者：陈实[1] 周志斌[1] 郭毅[1] 唐冰杉[1] 王晓萍[1] 

机构地区：[1]暨南大学医学院第二附属医院神经内科,深圳518020

出　　处：《国外医学（脑血管疾病分册）》2004年第4期260-263,共4页Foreign Medical Sciences Cerebrovascular Diseases

基　　金：深圳市科技局资助(No.2001004059)

摘　　要：目的:研究血清基质金属蛋白酶-9(MMP-9)水平与缺血性卒中梗死体积和预后的关系,并探讨其潜在的机制。方法:对纳入研究的124例缺血性卒中患者在起病后24 h抽取肘静脉血,用酶联免疫吸附法测定MMP-9水平,同时用免疫比浊法测C反应蛋白(CRP)水平。根据卒中患者临床神经功能缺损程度评分标准在患者人院和出院时进行评分,所有患者均经CT或MRI确诊。结果:脑梗死组MMP-9、CRP、三酰甘油水平及白细胞计数均明显高于腔隙性梗死组和对照组,分别为(731.55±226.18):(622.64±196.72):(343.56±108.74)ng/ml,P<0.01;(8.65±3.77):(6.97±4.36):(3.85±1.28)mg/ml,P<0.01;(1.91±0.96):(1.52±O.85):(1.47±0.76)mmol/L,P<0.01;(9.17±1.99):(8.38±1.84):(8.25±1.72)×109/L,P<0.01。相关分析表明,MMP-9水平与CRP和白细胞计数呈直线正相关(r=0.224,P=0.013;r=0.289,P=0.001),与预后呈等级相关(r=0.180,P=0.046)。结论:脑梗死急性期血清MMP-9水平可能与梗死体积和近期预后密切相关。Objectives: To investigate the relationship of serum matrix metalloproteinase-9 (MMP-9) levels with the infarct volumes of ischemic stroke and its prognosis, and to explore its potential mechanism. Methods: One hundred and twenty-two patients with ischemic stroke were included in the study and the blood samples from their cubital veins were collected 24 hours after the onset. Serum MMP-9 levels were measured by enzyme-linked immunosorbent assay. Serum C-reactive protein (CRP) levels were measured by immunoturbidimetry assay (ITA) at the same time. All patients' neurological defects were scored both at admission and discharge, and all patients were identified by CT/MRI. Results: Serum MMP-9 levels, serum CRP levels, trighyceride (TG) levels and differential leukocyte count were significantly higher in the infarct group than those in the lacunar infarct group and the control group. They were731. 55 ±226. 18 vs 622. 64 ±196. 72 vs 343. 56 ±108. 74 ng/ml (P<0. 01); 8. 65 ±3. 77 vs 6. 97 ±4. 36 vs 3. 85 ± 1. 28 mg/ml (P<0. 01); 1.91±0.96 vs 1.52±0.85 vs 1.47±0. 76 mmol/L (P <0. 01); (9. 17 ±1. 99)×109/ L vs (8. 38 ± 1. 84)× 109/L vs (8. 25 ±1. 72) × 109/L(P <0. 01), respectively. Correlation analysis showed that MMP-9 levels had linear positive correlation with CRP levels and differential leukocyte count (r =0. 224, P =0. 013; r =0. 289, P =0. 001), and had rank correlation with prognosis ( r =0. 180, P = 0. 046). Conclusion: Serum MMP-9 levels may be closely associated with the infarction volumes and the recent prognosis in acute cerebral infarction.

关 键 词：血清 基质金属蛋白酶-9 脑梗死 预后 临床标志物 梗死体积 

分 类 号：R743.3[医药卫生—神经病学与精神病学]