血清基质金属蛋白酶-3水平在不同OCSP亚型老年急性脑梗死患者血清中的变化

Changes of serum matrix metalloproteinase-3 levels in elderly patient with different subtypes of acute cerebral infarction

目的观察不同临床亚型老年急性脑梗死（ACI）患者血清基质金属蛋白酶（MMP）-3水平变化及其与预后的关系。方法应用ELISA法检测258例发病3d内的老年ACI患者（病例组）和60例对照者（NC组）血清MMP-3，病例组根据牛津郡社区卒中计划（OCSP）分型标准分为完全性前循环型脑梗死（TACI）、部分前循环型脑梗死（PACI）、后循环型脑梗死（PoCI）、腔隙性脑梗死（LACI）4大亚型，并进行美国国立卫生院卒中量表（NIHSS）、改良Rankin评分（mRS评分），分析不同CCsP亚型（MM]P）-3水平，变化及其与预后的相关性。结果TACI、PACI、POCI患者血清MMP-3水平较NC组明显升高，差异有统计学意义（P〈0．01），LACI较NC组明显升高，差异有统计学意义（P〈0．05）。TACI亚型90d时mRS评分0～2分患者比率最低，LACI亚型90d时mRS评分0～2分患者比率最高，其次为PACI、POCI亚型。结论血清MMP-3随CCsP亚型的不同而变化，发病后血清MBP可以作为老年脑梗死患者预后判断的指标之一。

Objective To investigate pattern of fluctuations and clinical significance of serum matrix metalloproteinase （MMP）-3 levels in patient with different subtypes of acute cerebral infarction and its relationship. Methods The levels of MMP-3 were detected by ELISA in 258 cerebral infarction patients （CI group）while 60 healthy donors were served as control group （NC group）. All ACI patients were classified into 4 groups based on the Oxfordshire community stroke project （OCSP） criteria. Then the relationships between MMP-3 level and mRS in different OCSP subtypes were analyzed. Results The level of MMP-3 in TAC, PACI and POCI was significantly higher than that in NC group （P 〈 0.01）. The increase level of MMP-3 in LACI subtype was high- er than that of NC group （ P 〈 0.05 ）. Compared to the control group, the level of MMP- 3 in TACI, PACI and POCI was significantly different from each other （P〈 0.01 ）. MRS 0--2 score of LACI subtype was the highest, followed by that in PACI, POCI subtype, and it was the lowest in TACI subtype. Conclusion The serum MMP-3 level changes with different clarifications of OCSP subtype and it can be a marker indicating severity of cerebral infarction in elderly patients.