成年型烟雾病患者血管内皮生长因子和基质金属蛋白酶-9血清水平与Suzuki分级的关系

Relationship between serum levels of vascular endothelial growth factor and matrix metalloproteinase-9 and Suzuki＇ s grading in adult moyamoya disease

目的探讨成年型烟雾病（moyamoya disease，MMD）患者血管内皮生长因子（vascular endothelial growth factor，VEGF）和基质金属蛋白酶-9（matrix metalloproteinase-9，MMP-9）血清水平及其与Suzuki分级的关系。方法从南京卒中注册系统中提取2009年4月至2011年1月间以短暂性脑缺血发作或首发卒中的52例住院或门诊复诊的成年型MMD患者。同时选取16名性别和年龄与MMD患者相配匹的健康人作为对照组。通过酶联免疫吸附分析法，比较MMD患者VEGF和MMP-9血清水平与健康对照人群间的差异；根据Suzuki6级分级标准，将MMD患者分为不同亚组，分别分析不同亚组VEGF和MMP-9血清水平与Suzuki分级的相关性；另外，对MMD患者VEGF和MMP-9血清水平的相关性亦作了分析。结果缺血型和出血型MMD患者VEGF血清水平分别为（289．4±69．2）pg／ml和（324．3±95．6）pg／ml，均高于健康对照组[（63．5±7．6）pg／ml；F=69．43；P〈0．01]；缺血型和出血型MMD患者MMP-9血清水平分别为（499．4±76．2）ng／ml和（531．2±100．2）ng／ml，亦均高于健康对照组[（257．1±30．7）ng／ml；F=66．023；P〈0．01]。随着Suzuki分级的升高，VEGF和MMP-9血清水平呈现升高趋势，相关系数r分别为0．879（P〈0．01）和0．838（P〈0．01）。另外，VEGF和MMP-9之间存在正向线性相关（r=0．590，P〈0．01）。结论成年型MMD患者VEGF和MMP-9血清水平高于健康人群，提示参与了血管新生；随着患者病情的进展，VEGF和MMP-9血清水平呈现升高趋势，提示VEGF和MMP-9血清水平能反映患者的病变严重程度。

Objective To investigate the relationship between serum levels of vascular endothelial growth factor （ VEGF ） and matrix rnetalloproteinase-9 （ MMP-9 ） and Suzuki＇ s grading system in adult moyamoya disease （MMD）. Methods Fifty-two adult patients with MMD, who were diagnosed in Jinling hospital between April 2009 and January 2010, were retrieved from the Nanjing Stroke Registry Program （NSRP）. Sixteen sex- and age-matched healthy individuals with MMD patients consisted of the control group. Using enzyme-linked immunosorbent assay, serum concentrations of VEGF and MMP-9 were compared between adult MMD patients and healthy individuals. By Suzuki＇ s six-grading system, patients were divided into different subgroups, and the correlation of serum levels of VEGF and MMP-9 corresponding to different subgroup and Suzuki＇ s grading was respectively analyzed. In addition, the correlation of serum levels of VEGF and MMP-9 was also evaluated. Results Serum VEGF concentrations in isehemie and hemorrhagic MMD patients was respectively （ 289.4± 69. 2 ） pg/ml and （ 324. 3 ± 95.6 ） pg/ml and were significantly higher compared to those in healthy controls （ 63.5 ± 7.6 ） pg./ml ; F = 69.43, P 〈 0. 01 ）.Similar findings were observed for MMP-9 （ （499.4 ± 76. 2） ng/ml and （531.2 ± 100. 2） ng/ml versus （257. 1 ± 30. 7） ng/ml; F = 66. 023,P 〈 0. 01 ）. With the increase of Suzuki＇ s grading, serum levels of VEGF and MMP-9 respectively showed a high trend （r = 0. 879, P 〈 0. 01 ; r = 0. 838, P 〈 0. 01 ）. In addition, a positive correlation between serum levels of VEGF and MMP-9 was found in the MMD group（ r = 0. 590, P 〈 0. 01 ）. Conclusion The results show that serum levels of VEGF and MMP-9 in adult MMD are higher than those in healthy controls, which may play a role in neovascularization in MMD, and moreover, serum levels of VEGF and MMP-9 show a high trend with the progression of MMD, which suggest that serum levels of VEGF and MMP-9 can reflect the severity of MMD.