脑出血患者血清基质金属蛋白酶水平与脑水肿和神经损害的关系

Relationship between levels of serum matrix metalloproteinases and brain edema and neurologic impairment in patients with intracerebral hemorrhage

目的探讨脑出血患者血清基质金属蛋白酶(MMPs)水平与脑水肿和神经功能损害的关系。方法应用酶联免疫吸附法测定31例脑出血患者发病后1d、3d、7d和14d时血清MMP-9和MMP-2水平;发病当日及14d时头颅CT测定血肿及其周围脑水肿体积,同时进行卒中评分量表(NIHSS)评分。结果血清MMP-9、MMP-2水平发病后各时间点明显高于正常对照组(均P<0.05);发病7d及14d时MMP-9水平与血肿周围水肿体积呈正相关(r=0.748,P<0.001;r=0.436,P<0.05),与血肿体积及NIHSS评分无相关;各时间点MMP-2水平与血肿体积、血肿周围水肿体积及NIHSS评分无相关。结论脑出血后MMP-9过表达参与血肿周围水肿的形成。

Objective To investigate the relationship between levels of serum matrix metalloproteinases （MMPs） and brain edema and neurologic impairment in patients with intracerebral hemorrhage（ICH ）. Methods The levels of serum MMP-9 and MMP-2 in 31 patients with ICH were tested with ELISA for at 1 d, 3 d,7 d and 2 weeks after onset. The volumes of hematoma and its peripheral edema were evaluated by CT, the neurologic impairment was evaluated by NIHSS at 1 d and 14 d after onset. Results Levels of serum MMP-9 and MMP-2 were significant higher in ICH group at each time point after onset than those in normal control group （ all P 〈 0. 05 ）. Levels of serum MMP-9 at 7 d and 14 d after onset were positively related with brain edema volume （ r = 0. 748, P 〈 0. 001, r =0.436,P 〈0. 05）. Both levels of serum MMP-9 and MMP-2 were not related with hematoma volume and NIHSS. The levels of serum MMP-2 was not related with brain edema volume. Conclusion Overexpressed MMP-9 after ICH is related with brain edema.