脑梗死患者血清基质金属蛋白酶2和C反应蛋白作用机制的研究

Study on mechanisms of roles of serum MMP-2 and CRP in cerebral infarction patients

目的探讨基质金属蛋白酶2(MMP-2)和C反应蛋白(CRP)在脑梗死发病过程中的作用机制。方法选择48例急性初发脑梗死患者为病例组,行牛津郡社区脑卒中项目(OCSP)临床分型,同期选择健康体检者50例为对照组。分别在发病48 h内、第7、14天用酶联免疫吸附法测定MMP-2水平,同时用免疫比浊法测定CRP水平,并进行相关分析。结果病例组患者血清MMP-2、CRP水平均明显高于对照组(P<0.05),且增高幅度在OCSP不同临床分型中表现不同。血清MMP-2和CRP与脑梗死体积、患者神经功能缺损程度呈正相关。血清MMP-2与CRP呈直线正相关(r=0.829,P<0.05)。logistic回归显示,发病48 h内的血清MMP-2、CRP水平是患者预后的独立预测因素。结论血清MMP-2和CRP可能参与脑梗死后缺血再灌注脑损伤,而且两者存在密切联系。

Objective To study mechanisms of roles of MMP-2 and CRP in acute cerebral infarction. Methods Forty-eight cases of acute cerebral infarction patients as case group and 50 health examination persons as control group were selected. The serum levels of MMP-2 and CRP within 48 hours,on 7th and 14th days after onset were measured and the correlations between MMP-2, CRP, clinical classification, the volume of infarction, degree of neurofunction impairment and prognosis were analyzed. Results The serum levels of MMP-2 and CRP of case group were obviously higher than those of control group. There were obvious positive correlations of MMP-2 and CRP levels to volume of infarct and degree of neurofunction impairment. High levels of them were different in different types of Oxfordshire community stroke project. MMP-2 and CRP were positively linearly correlated （r = 0. 829,P 〈 0.05） and were independent predictors of prognosis indicated by logistic regression analysis. Conclusions MMP-2 and CRP are possibly involved in brain ischemia/reperfusion injury and are closely associated. Early serum levels of MMP-2 and CRP may predict infarct volume, severity, clinical classification and prognosis.