新生儿缺氧缺血性脑病血清基质金属蛋白酶-9及其抑制剂的变化及意义

Changes and clinical significance on level of serum matrix metalloproteinase-9 and its inhibitor of neonatal with hypoxic ischemic encephalopathy

目的探讨缺氧缺血性脑病新生儿血清MMP-9、TIMP-1水平动态变化及其临床意义。方法观察组73例(轻度组30例,中度组25例,重度组18例),健康足月新生儿30例为对照组。采用酶联免疫吸附试验(ELISA)测定患儿生后24 h、72 h、7 d时血清MMP-9、TIMP-1水平及其二者比值,并与对照组进行比较。结果缺氧缺血性脑病患儿轻度组、中度组和重度组在生后24 h、72h、7d血清中基质金属蛋白酶-1和基质金属蛋白酶组织因子-1及其二者比值均明显高于对照组(P<0.05,0.01),且重度组较轻度组、中度组明显增高(P<0.05,0.01),其差异具有统计学意义。各组在生后三个时间点的比较,除对照组外,其余各组24h、72 h均高于7 d(P<0.05),且72 h高于24h(P<0.05)。结论动态检测HIE患儿血清中MMP-9及TIMP-1水平,对指导临床诊断和治疗具有一定指导意义,并可通过其变化来推测中枢神经系统并发症的发生,对了解HIE脑损伤程度及判断预后具有重要价值。

Objective To approach clinical significance and dynamic changes on the level of serum matrix metalloproteinase-9 and its inhibitor of neonatal with hypoxic ischemic encephalopathy.Methods Observed group 73 cases（mild group 30 cases,moderate group 25 cases,severe group 18 cases）,30 cases of healthy newborns as control group.The levels of MMP-9 and TIMP-1 in blood plasma in after birth within 124 h、72 h、7 d were detected by ELISA,and compared with the control group.Results The levels of serum MMP-9,TIMP-1 and MMP-9 / TIMP-1 in neonatal with hypoxic ischemic encephalopathy（mild group,moderate group,severe group）were significantly higher than those in control group（P0.05,0.01）.Which in severe group were significantly higher（P0.05,0.01） than that of mild group and moderate group,the difference was statistically significant.Which were compared by each group after birth at three time points,in addition to the control group,those in other groups after birth 24h,72 h were higher than 7 d（P0.05）,and those in after birth 72 h were higher than 24h（P0.05）.Conclusions Serum MMP-9 and TIMP-1 levels of neonatal with hypoxic ischemic encephalopathy were detected dynamically.Which had a certain guide significance for clinical diagnosis and treatment,and development of central nervous system complications through its changes,which had important value for understanding the extent of brain injury of HIE and deciding prognosis.