血清S100B、MMP-2及炎性标志物测定在氯吡格雷治疗急性缺血性脑卒中的临床意义

Clinical significance of S100B,MMP-2 and inflammatory markers determination in clopidogrel treatment of acute ischemic stroke

目的探讨血清中S100B、基质金属蛋白酶-2(MMP-2)和血清炎性标志物水平与急性缺血性脑卒中的相关性及其在氯吡格雷治疗急性缺血性脑卒中的临床意义。方法选择该院2011年7月至2013年12月收治的诊断为急性缺血性脑卒中的患者134例,按照治疗方式不同将所有患者分为观察组(72例)和对照组(62例)。观察组患者给予常规治疗联合氯吡格雷治疗,对照组患者给予常规治疗联合阿司匹林治疗,对比观察两组患者的疗效,治疗前后的神经功能缺损程度评分,以及血清S100B、MMP-2和血清炎性标志物水平,同时进行相关性分析。结果观察组患者的治疗总有效率明显高于对照组,差异具有统计学意义(P<0.05),同时两组患者经过治疗后神经功能缺损程度评分均明显下降,同时治疗后7d及治疗后14d观察组患者的评分均明显低于对照组,差异均具有统计学意义(P<0.05);经过治疗两组患者的指标均有所降低,其中观察组患者治疗后各指标均明显低于治疗前,而对照组患者的炎性指标水平也明显低于治疗前,差异均具有统计学意义(P<0.05),但S100B及MMP-2与治疗前相比差异无统计学意义(P>0.05),同时,治疗后观察组患者的各项指标均显著低于对照组,差异具有统计学意义(P<0.05);经过Pearson相关分析发现,患者治疗前后的神经功能缺失评分与血清中S100B、MMP-2、hs-CRP、IL-6、PS等水平呈负相关。结论氯吡格雷对急性缺血性脑卒中患者具有明显临床效果,同时能够对患者血清中的S100B、MMP-2水平及炎性因子的表达产生影响。

Objective To investigate the correlation between serum S100B ,MMP2 and serum inflammatory marker levels with acute ischemic stroke and its clinical significance in clopidogrel treatment of acute ischemic stroke . Methods 134 cases of acute ischemic stroke in our hospital from July 2011 to December 2013 were divided into the observation group（72 cases） and the control group（62 cases） according to the different treatment modes .The observation group was given the conventional therapy combined with clopidogrel treatment ,while the control group was given the conventional therapy combined with aspirin treatment .The curative effects ,neurological function defect degree scores before and after treatment ,serum S100B ,MM P2 and serum inflammatory marker levels were compared between the two group .Meanwhile the correlation analysis was performed .Results The total effective rate in the observation group was significantly higher than that in the control group with statistically significant difference （P 〈0 .05） ,meanwhile the neurological deficit degree scores after treatment in the two groups were significantly decreased ,moreover which on 7 ,14 d after treatment in the observation group were significantly lower than those in the control group ,the differences were statistically significant （P 〈 0 .05） ;the indexes levels after treatment in the two groups were decreased ,but the levels of various indexes after treatment in the observation group were significantly lower than those before treatment ,while the levels of inflammatory markers in the control group were significantly lower than those before treatment ,the differences were statistically significant （P〈 0 .05） ,but the S100B and MMP2 levels had no statistically significant differences between before and after treatment （P〉0 .05） ,the levels of indexes after treatment in the observation group were significantly lower than those in the control group with statistically significant difference （P〈 0 .05） ;the Pearson correlation analysis showed that the nerve function defects scores before and after treatment were negatively correlated with serum S100B ,MMP2 and the inflammatory markers of hsCRP ,IL6 and PS .Conclusion Clopidogrel has significantly clinical effect in treating acute ischemic stroke ,also can has the influence on the serum S100B and MM P2 levels ,and the expression of inflammatory cytokines .