血清基质金属蛋白酶-9、同型半胱氨酸水平与脑梗死关系的研究

Research on the relationship of matrix metalloproteinase- 9,homocysteine levels and cerebral infarction

目的探讨脑梗死患者血清中基质金属蛋白酶-9(MMP-9)、同型半胱氨酸(Hcy)水平的变化及其临床意义。方法连续收集住院150例脑梗死患者为研究组,根据头颅CT检查有无出血情况分为出血转化组(HT)和非出血转化组(non-HT),根据脑梗死面积大小分型,用ELISA方法检测患者血MMP-9水平,并结合患者临床症状及头颅CT改变进行分析。结果患者组血清MMP-9浓度[(339.2±192.4)ng/ml]、Hcy浓度[(23.18±7.33)μmol/L]与对照组、脑梗死组相比较都明显升高(P<0.01)。MMP-9以HT组升高明显,且大梗死灶组患者血清MMP-9水平高于中、小梗死灶组,3组之间比较差异均有统计学意义(P<0.05)。而Hcy浓度在HT和non-HT两组之间比较没有明显差异,大梗死灶组与中、小梗死灶组之间比较差异也无统计学意义(P>0.05)。结论提示MMP-9、Hcy可能参与了脑梗死的发病机制,是脑梗死的独立危险因素之一。血清MMP-9水平对病情的严重程度和预后有预示作用,并对脑梗死出血转化有早期预测作用,Hcy则没有相应的意义。检测MMP-9水平可增加临床溶栓治疗的安全性,对预防出血转化,改善预后有重要意义。

Objective To investigate thedynamic changes of serum matrix metalloproteinase- 9（ MMP- 9） levels and homocysteine（ Hcy） levels in patients with cerebral infarction and its their clinical significance. Methods One hundred and fifty 150 hospitalized patients with cerebral infarction were continuously collected as study group. According to whether there is hemorrhage with the head computerized tomography examination,patients were divided into hemorrhagic transformation（ HT） group and non- hemorrhagic transformation（ non- HT） group. Based on the size of the infarction area we also divide patients into groups to test their blood MMP- 9 levels by enzyme- linked immuno sorbent assay（ ELISA） and to analyze combined with patients clinical symptoms and their cranial CT changes. Results The serum MMP- 9 level in the patients with HT [（ 339. 2 ±192. 4） ng /ml]was significantly higher than that in the cerebral infarction patients（ P 0. 01）. MMP- 9 level in HT group rises obviously and it was higher in large infarction group than that in medium or small infarction group. The comparison among three groups has no statistical significant,nor does in the comparison between large infarction group and medium,small infarction group,because there is no obvious difference in the comparison between HT group and non- HT group（ P 0. 01）. Conclusion MMP- 9 and Hcy may be involved in the pathogenesis of cerebral infarction,which is one of the independent risk factors of cerebral infarction. The serum level of MMP- 9 may indicate the severity and prognosis of disease,and devotes early prediction to the hemorrhagic transformation of cerebral infarction. Hardly does Hcy have the relevant significance. Detection of MMP- 9 level may increase the safety of clinical treatment,prevention of hemorrhagic transformation,and has significance for improving the prognosis.