急性脑梗死患者血清MMP-2、MMP-9与血糖、胰岛素及IGF-1相关性研究

Relationship between serum MMP-2,MMP-9 and blood glucose,insulin,IGF-1 in patients with acute cerebral infarct

目的观察急性脑梗死患者血清MMP-2、MMP-9和血糖、胰岛素、IGF-1动态变化,探讨急性缺血性脑损伤患者MMP-2和MMP-9与糖代谢物质的关系,研究应激性高血糖在急性缺血性脑损伤中的作用。方法实验分为5组:正常组(N组)、杏丁治疗梗死组(X组)、杏丁阿司匹林治疗梗死组(XA组)、杏丁阿司匹林小剂量胰岛素治疗梗死组(XY组)、糖尿病对照组(D组),每组15个样本。双抗体夹心ELISA法测定MM P-2、MM P-9,采用放射免疫法测定患者IGF-1、INS,化学法测定BG。结果X组、XA组、XY组、D组和N组MMP-2和MMP-9浓度比较明显增高(P<0.01);2h、24h、48h X组,XA组、XY组、D组和N组BG浓度比较明显增高(P<0.01);2h、24hX组,XA组、XY组、D组和N组INS浓度比较明显增高(P<0.05);D组和X组、XA组、XY组2周比较IGF-1浓度明显增高(P<0.01),其他各组数据间差异均无统计学意义(P>0.05)。结论脑缺血患者血清应激性高血糖和MMP-2、MMP-9水平无相关性,在急性缺血性脑损伤中应激性高血糖不会破坏血脑屏障的功能。MMP-2、MMP-9具有双重性作用,既具有脑保护作用,也有脑损伤作用。

Objective To observe relationship between serum MMP-2, MMP-9 and blood glucose,insulin,insulin-like growth factor-1 in cerebral ischemia infarct patients. Methods Observers were randomly divided into： normal groups（N）,infarct groups with xinding（X）,infarct groups with xinding and aspirin（XA）, infarct groups with xinding and aspirin and insulin（XY）, and diabetes groups（D）. MMP-2, MMP-9 were measured by enzyme linked immunosorbent assay,insulin-like growth factor-1 was measured by radioimmunity,blood glucose was measured by biochemistry. Results The serum concentration of MMP-2, MMP-9 in X, XA, XY,D groups was significantly higher than that of in normal groups（P〈0.01）;The serum concentration of blood glucose in X, XA, XY, D groups for 2h, 24h, 48 was significantly higher than that of in normal groups（P〈0.01） ; The serum concentration of insulin in X,XA,XY,D groups for 2h,24h was significantly higher than that of in normal groups（P〈0.05）;The serum concentration of IGF-1 in D group for 2w was significantly higher than that of in X,XA, XY groups（P〈0.01） ;There was no significant difference among other groups（P〈0.05）. Conclusion Activated hyper-glycaemia has no relationship with MMP-2, MMP-9 in cerebral ischemia infarct patients. MMP-2 and MMP-9 play dual roles in cerebral ischemia：brain protection and brain damage.