MMP-9、MMP-2、TIMP-1及TIMP-2水平对颅脑损伤患者预后评价的临床意义

Study on the clinical significance and prognostic evaluation of expression levels of MMP-9,MMP-2,TIMP 1 and TIMP-2 in patients with craniocerebral injury

目的探讨基质金属蛋白酶9(MMP-9)、基质金属蛋白酶2(MMP-2)、基质金属蛋白酶抑制剂1(TIMP-1)及基质金属蛋白酶抑制剂2(TIMP-2)水平对创伤性颅脑损伤(TBI)患者预后评价的临床意义。方法选取神经外科收治且经CT检查确诊的45例TBI患者作为TBI组,并依据Glasgow分级标准为轻、重两组。以同期来我院进行相关检查的12例正常健康者作为对照组。比较不同时间点(24 h、72 h以及120 h)TBI组与对照组脑脊液中的MMP-9、MMP-2、TIMP-1及TIMP-2表达水平。结果 1在24 h、72 h、120 h 3个时间点,TBI组患者脑脊液中的MMP-9、MMP-2、TIMP-1及TIMP-2的表达水平均显著高于对照组,差异具有显著(P<0.01)。2随着时间的进展,TBI组患者脑脊液中的MMP-9水平逐渐升高,TIMP-1水平逐渐降低,差异均有显著性(P<0.05),而MMP-2、TIMP-2的表达水平无显著变化(P>0.05)。3120 h范围内重度TBI患者组脑脊液中的MMP-2、TIMP-2的表达水平与轻度TBI患者组比较无显著差异(P>0.05);24 h时间点重度TBI患者组脑脊液中的MMP-9的表达水平显著高于轻度TBI患者组(P<0.05);120 h时间点重度TBI患者组脑脊液中的TIMP-1的表达水平显著高于轻度TBI患者组(P<0.05)。结论 TBI患者脑脊液中的MMP-9、TIMP-1短期内表达水平变化显著,且与患者的病情紧密相关,因此可作为观察患者临床预后的评价指标。

Objective To explore the clinical significance and prognostic evaluation of expression levels of MMP- 9,MMP- 2,TIMP-1 and TIMP- 2 in patients with craniocerebral injury. Methods A total of 45 patients with craniocerebral injury confirmed by CT scanning admitted in the Department of Neurosurgery of this hospital were allocated in TB1 group,and they were divided into mild group and severe group according to Glasgow grading standards. Twelve normal persons in this hospital for healthy check at the same period were listed in control group. The expression levels of MMP- 9,MMP- 2,TIMP- 1 and TIMP- 2 in cerebral spinal fluid detected at different time points（ 24 h,72 h and 120 h）were compared between patients in these 2 groups. Results ①The expression levels of MMP- 9,MMP- 2,TIMP- 1 and TIMP- 2 in cerebral spinal fluid in three detection points in TB1 patients were significantly higher,and the difference between these two groups was significant（ P〈0. 01）. ②The expression level of MMP- 9 in CSF of TB1 patients was gradually increased and their expression level of TIMP- 1 was decreased following the progress of time,and the difference was not statistically significant（ P〉0. 05）. ③The expression levels of MMP- 2 and TIMP-2 in cerebral spinal fluid of severe TB1 patients at 120 h time point were significantly higher than those in mild TB1 patients,and the difference was not significant（ all P〈0. 05）. The expression level of MMP- 9 in CSF of severe TB1 patients at 24 h check point was significantly higher than that of patients in mild TBI group（ P〈0. 05）; and the expression level of TIMP- 1 in CSF of severe TB1 patients at 120 h detection point was significantly higher than that of patients in mild TBI group（ P〈0. 05）. Conclusion The change in short term expression levels of MMP-9 and TIMP- 1 in cerebral spinal fluid of TB1 patients is significant and it is closely related to the condition of disease in patients,hence it can be applied as indicator for evaluation of the clinical prognosis of patients.