缺血性脑血管病患者血清基质金属蛋白酶水平及影响因素分析

Evaluation and correlation analysis of matrix metalloproteinase-9 in ischemic cerebral vascular disease

目的 比较急性脑梗死、短暂脑缺血发作（TIA）和陈旧脑梗死患者血清基质金属蛋白酶-9（MMP-9）水平并分析其影响因素。方法 缺血性脑血管病患者136例，分为急性脑梗死组57例，TIA组22例，陈旧脑梗死组57例，进行神经功能评分及血压、血常规、血脂、血糖检查。依据ELISA法进行血MMP-9测定。结果 MMP-9水平分别为急性脑梗死患者（444．13±418．46）ng／ml，TIA患者（374．36±278．31）ng／ml，陈旧脑梗死患者（231．11±367．43）ng／ml。急性脑梗死和TIA患者血MMP-9水平明显高于陈旧脑梗死患者（P〈0．05）。MMP-9水平与血白细胞水平（r=0．192，P=0．025）、低密度脂蛋白（r=0．261，P=0．002）、收缩压（r=0．232，P=0．006）呈正相关；与高密度脂蛋白（r=-0．219，P=0．01）和血糖（r=-0．254，P=0．003）呈负相关。MMP-9与收缩压（β=0．259，P=0．001）、血白细胞（β=0．209，P=0．008）、低密度脂蛋白（β=0．586，P=0．000）、胆固醇（β=-0．458，P=0．007）和血糖（β=-0．200，P=0．014）具有线性关系。结论 MMP-9水平在急性脑梗死及TIA时升高，收缩压、血白细胞和低密度脂蛋白均可能为其影响因素。

Objective To evaluate serum matrix metalloproteinase-9 （MMP-9） in acute ischemic stroke, transient ischemic attack （TIA）and old ischemic stroke patients. Methods 57 acute ischemic stroke patients, 57 old ischemic stroke patients and 22 TIA patients were included. Medical history was recorded and routine examinations were conducted. Serum MMP-9 was evaluated using ELISA method. Results MMP-9 concentration was significandy elevated in acute ischemic stroke（444. 13±418.46）ng/ml and TIA patients （374. 36±278.31 ）ng/ml, comparing with old ischemic stroke patients （231. 11±367.43 ） ng/ml （P 〈 0. 05 ）. White blood cell count（ r = 0. 192, P = 0. 025 ） , low density lipoprotein （ r = 0. 261 ,P = 0. 002 ） and systolic blood pressure （ r = 0. 232, P = 0. 006 ） positively correlated with MMP-9 level. High density lipoprotein （ r = - 0. 219, P = 0. 011 ） and blood glucose （ r = - 0. 254, P = 0. 003 ） negatively correlated with MMP-9 level. There was linear relationship between MMP-9 level and systolic blood pressure （β = 0. 259, P = 0. 001 ） , white blood cell count （β = 0. 209, P = 0. 008 ） , low density lipoprotein （β = 0. 586, P = 0. 000 ） , cholesterol（β = - 0.458, P = 0.007 ） and blood glucose （β = - 0.2, P =0. 014）. Conclusion MMP-9 level elevated in acute ischemic stroke and TIA patients. SBP, WBC and LDL could be its influencing factors.