缺氧缺血性脑病患儿血清MMP-9水平动态变化及意义

Dynamic Changes of Levels of Serum MMP-9 in Patients with Hypoxic-ischemic Encephalopathy and Its Clinical Significance

目的:研究缺氧缺血性脑病(hypoxic ischemic encephalopathy,HIE)新生儿血清中金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)水平的动态变化,探讨MMP-9水平和新生儿脑缺氧缺血后脑损伤程度之间的关系。方法:用酶联免疫吸附法测定24例HIE患者发病后1天、3天、7天血清MMP-9浓度,并与健康对照组比较。结果:HIE患者发病后1天、3天、7天,血清MMP-9水平分别为(34.11±1.10)pg/mL、(37.50±4.96)pg/mL、(33.42+0.73)pg/mL,均高于对照组水平(31.48±3.27)pg/mL,差异有统计学意义(P<0.05),以发病第3天水平最高,此后呈降低趋势。重度HIE患者发病后第3天血清MMP-9水平高于中、轻度组(P<0.05)。阿氏评分值与HIE发病后第3天血清MMP-9水平呈直线负相关(r=-0.692 p=0.000)。结论:HIE患者发病早期血清MMP-9水平即升高,提示MMP-9可能参与了HIE的发病机制。病情越严重,血清MMP-9升高越明显,提示血清MMP-9水平可能是判断病情的严重程度及预后的辅助指标。

Objective To study the dynamic changes of serum matrix metalloproteinase-9 （MMP-9） level in newborns with neonatal hypoxic-ischemic encephalopathy （HIE） as well as the relationship between MMP-9 levels and brain damage. Method The blood samples of 24 cases of neonates with HIE were collected at 1 d, 3 d, 7d after onset. The levels of MMP-9 in sera were detected by ELISA and compared with healthy neonates control group （n=20）. Results The serum MMP-9 levels in HIE patients were （34.11± 1.10 ） pg/mL, （37.50± 4.96） pg/mL, （33.42± 0.73） pg/mL respectively at 1d,3d,7d after the onset, which were higher than those in control group （31.48± 3.27） pg/mL （P〈0.05）. The MMP-9 level in the severe patients was higher than those in the medium or the mild group at 3d after HIE onest （P〈0.05）. The Apgar scores of the newborns were negatively correlated with serum MMP-9 level at 3d （r=-0.692, P=0.000）. Conclusions The MMP-9 level increases in the early stage of HIE. MMP-9 is involved in the pathogenesis of neonatal HIE, and the serum level of MMP-9 might be adjuvant indexes in the diagnosis and prognosis of neonatal HIE.