rTMS对缺血性脑卒中患者血清MMP-9、Ang-Ⅰ与NSE水平变化的影响

Effect of rTMS on changes in serum MMP⁃9,Ang⁃I and NSE levels in patients with ischemic stroke

目的探讨rTMS对缺血性脑卒中患者血清基质金属蛋白酶-9(MMP-9)、人血管生成素-1(Ang-Ⅰ)与神经元特异性烯醇化(NSE)水平变化的影响。方法选取石家庄市人民医院2021年4月至2022年9月收治的122例缺血性脑卒中患者为研究对象,根据康复治疗方式的不同分为对照组(n=37,常规康复治疗)、高频刺激组(n=45,常规康复治疗+高频rTMS)和低频刺激组(n=40,常规康复治疗+低频rTMS);比较三组运动功能和神经功能恢复情况、血清MMP-9、Ang-Ⅰ与NSE水平变化情况、神经电生理指标[运动诱发电位(MEP)潜伏期和中枢运动传导时间(CMCT)]。结果治疗后,高频刺激组和低频刺激组Fugl-Meyer运动评分均比对照组高,NIHSS评分均比对照组低,差异有统计学意义(P<0.05),高频刺激组和低频刺激组Fugl-Meyer运动评分、NIHSS评分比较,差异无统计学意义(P>0.05);高频刺激组和低频刺激组MEP潜伏期和CMCT均低于对照组,差异有统计学意义(P<0.05),高频刺激组和低频刺激组MEP潜伏期和CMCT比较差异无统计学意义(P>0.05);高频刺激组和低频刺激组MMP-9、NSE水平均比对照组低,Ang-Ⅰ水平比对照组高,差异有统计学意义(P<0.05)。高频刺激组和低频刺激组MMP-9、NSE、Ang-Ⅰ水平相比较,差异无统计学意义(P>0.05)。结论rTMS可以降低缺血性脑卒中患者体内血清MMP-9、NSE水平,提高Ang-Ⅰ水平,利于患者运动功能和神经功能的恢复。

Objective To explore the effects of rTMS on the changes in serum matrix metallopro⁃teinase⁃9(MMP⁃9),human angiopoietin⁃1(Ang⁃I)and neuron⁃specific enolization(NSE)levels in patients with ischemic stroke.Methods One hundred and twenty⁃two ischemic stroke patients admitted to Shijia⁃zhuang People's Hospital from April 2021 to September 2022 were selected for the study.They were divided into three groups:a control group(n=37)receiving conventional rehabilitation therapy,a high⁃frequency stim⁃ulation group(n=45),receiving conventional rehabilitation therapy+along with high⁃frequency rTMS,and a low⁃frequency stimulation group(n=40),receiving conventional rehabilitation therapy+along with low⁃fre⁃quency rTMS.The purpose of this division was to compare motor function and neurological function recovery,changes in serum MMP⁃9,Ang⁃I and NSE levels,and neurophysiological indexes such as motor evoked poten⁃tial(MEP)latency and central motor conduction time(CMCT)among the three groups.Results After treat⁃ment,the Fugl⁃Meyer exercise score of the observation group was higher than that of the control group,and the NIHSS score of the observation group was lower than that of the control group,and the difference was sta⁃tistically significant(P<0.05).There was no statistically significant difference in the Fugl⁃Meyer motor score and NIHSS score between the high⁃frequency stimulation group and the low⁃frequency stimulation group(P>0.05).MEP latency and CMCT in the high⁃frequency stimulation group and the low⁃frequency stimulation group were lower than those in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in MEP latency and CMCT between the high⁃frequency stimula⁃tion group and the low⁃frequency stimulation group(P>0.05).The levels of MMP⁃9 and NSE in the high⁃fre⁃quency stimulation group and the low⁃frequency stimulation group were lower than those in the control group.The levels of Angⅰin the high⁃frequency stimulation group and the low⁃frequency stimulation group were higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion rTMS can decrease serum levels of MMP⁃9 and NSE in patients with ischemic stroke and increase the level of ANG⁃I.This is beneficial for the recovery of motor and neurological functions in patients.