急性脑出血患者血清VEGF和MMP-9水平的变化及其意义

Dynamic changes of serum VEGF and MMP-9 in acute cerebral hemorrhage and clinical significance

目的探讨脑出血患者血清血管内皮生长因子(VEGF)和基质金属蛋白酶-9(MMP-9)水平的动态变化及其临床意义。方法选取发病在24 h内的急性幕上脑出血患者61例为脑出血组,46例健康体检者为对照组,在急性脑出血发病1d、3d、7d、14d时用酶联免疫法测定患者血清中VEGF和MMP-9含量,并分析VEGF和MMP-9水平与出血灶周围脑水肿体积的关系。结果 (1)急性脑出血组与健康对照组比较,各时点血清VEGF及MMP-9水平均明显增高(P<0.01;<0.01),且呈动态变化;(2)血清VEGF、MMP-9与出血灶周围水肿体积绝对值及水肿体积相对值密切相关;(3)脑出血后24 h～3 d内,血清VEGF与MMP-9呈正相关(r=0.619,P<0.01)。结论急性脑出血患者血清VEGF和MMP-9均显著升高,二者可能协同参与脑出血急性期脑水肿和损伤的病理发展。

Objective To study the levels of serum vascular endothelial growth factor （VEGF） and matrix metalloproteinase-9 （MMP-9） in patients with acute cerebral hemorrhage （ACH） and the clinical significance. Methods 61 patients with ACH were chosen as ACH group,46 healthy subjects as control group. In ACH group,serum VEGF and MMP-9 levels were determined on days 1,3,5,7,14 after onsets, and the correlation of serum VEGF or MMP-9 with edema volume of cerebral hemorrhage tissue was analysed. Results （1） Both serum VEGF levels at 24 h,3 d,7 d,14 d and serum MMP-9 levels at 24 h,3 d, 7 d were increased significantly in ACH group as compared with control group （P 〈 0.01 ; 〈 0.01 ）, and they showed dynamic change. （2） Not only the serum of VEGF but also MMP-9 in ACH group showed positively correlation with edema volume of cerebral hemorrhage tissue. （ 3 ） In the time of 24h-3d after cerebral hemorrhage, the serum of VEGF showed positively correlation with MMP-9 （ r = 0. 619, P 〈 0.01 ）. Conclusions The levels of serum VEGF and MMP-9 increased in patients with ACH. They might take part in the pathology process of brain edema and injury of synergy.