不同海拔地区急性脑梗死患者基质金属蛋白酶-2和周围血白细胞计数变化

A study on the change of matrix metalloproteinase-2 and peripheral white blood cells of acute cerebral infarction patients at different altitudes

目的观察不同海拔(高、中、低)地区急性脑梗死(acute cerebral infarction,ACI)患者血清基质金属蛋白酶-2(matrix metalloproteinase-2,MMP-2)及周围血白细胞计数(white blood cell count,WBC)含量的变化及其与脑梗死严重程度的关系。方法收集三个地区常住汉族居民ACI组139例并与对照组150例比较,用酶联免疫吸附法检测MMP-2,用电阻法检测WBC水平,比较ACI组血清MMP-2、WBC水平在发病时增高和下降的趋势。结果不同海拔各对照组相比,随海拔升高,MMP-2水平增高,即海西(高海拔()1.41±0.39)高于西宁(中海拔)(1.37±0.27)、西宁高于四川(低海拔)(1.28±0.21)(P<0.05)。随海拔升高ACI组患者血清MMP-2水平以第7 d(5.75±1.19,5.23±1.12,4.15±0.97)增高明显,WBC重型组在48h(12.93±2.11,12.11±1.74,11.15±1.68)内增高明显(P<0.05)。MMP-2在不同海拔与梗死体积大小、患者神经功能缺损程度呈正相关,与预后呈负相关,WBC在大梗死组与梗死体积大小呈正相关。结论不同海拔MMP-2、WBC含量可帮助判断ACI病灶大小、病情轻重、估计预后。

Objective To investigate the changes of the serum levels of matrix metalloproteinase- 2 （MMP-2） and peripheral blood leukocytes content and its relationship with the severity of cerebral infarction in acute cerebral in-farction（ACI）patients at different altitudes （high, middle and low）. Methods One hundred thirty-nine cases and 150 healthy controls were included in the present study. Enzyme linked immunosorbent method was used to detect MMP-2 and WBC levels. Results MMP-2 levels increased as the altitude increased in controls. The MMP-2 in a descending or-der was 1.41±0.39 in Haixi （high altitude）, 1.37±0.27 in Xining （middle altitude） and 1.28±0.21 in Sichuan （low altitude） （P〈0.05）. The serum levels of MMP-2 were significantly increased at 7 d at different altitudes （5.75±1.19, 5.23±1.12 and 4.15 ± 0.97 in low, middle and high altitudes, respectively）. The WBC were significantly increased at different alti-tudes （12.93±2.11, 12.11±1.74 and 11.15±1.68 in low, middle and high altitudes, respectively） within 48 h in severe ACI group （P〈0.05）. MMP-2 levels in different altitudes were positively associated with the infarction size and the degree of neurological deficit, while were negatively correlated with the prognosis. The WBC in large infarction group were positive-ly correlated with the infarct size. Conclusions The levels of MMP-2 and WBC in different altitudes may be helpful in determining the ACI lesion size and the severity of the illness as well as estimating the prognosis.