蛛网膜下腔出血后血清MMP-9和TIMP-1对CVS的预测作用研究

The study of the serum MMP-9 and TIMP-1 for the prediction of cerebral vasospasm after subarachnoid hemorrhage

目的探讨基质金属蛋白酶-9(MMP-9)和基质金属蛋白酶抑制因子-1(TIMP-1)的表达水平及其在蛛网膜下腔出血(SAH)中预测脑血管痉挛(CVS)发生的意义。方法采用酶联免疫法检测32例蛛网膜下腔出血(SAH)患者作为实验组,分别于SAH后术前,术后第1、3、7天及出院当天采血,检测血清中MMP-9和TIMP-1的水平,并与20例体检正常者(对照组)进行比较。结果除SAH的CVS患者在第7天TIMP-1蛋白表达趋于正常外,CVS和非CVS患者在术后各时间点观察组血清MMP-9和TIMP-1水平均明显高于对照组,差异有统计学意义(P<0.05),且与患者血浆MMP-9和TIMP-1呈显著正相关(P<0.05);对照组MMP-9和TIMP-1无显著相关性(P>0.05),且SAH的CVS患者较非CVS患者MMP-9在术后第3、7天,增高更明显,SAH术后第3天TIMP-1的表达在CVS和非CVS均明显增高,而在CVS患者在第7天蛋白表达趋于正常。结论 SAH的CVS和非CVS患者血清MMP-9和TIMP-1的蛋白均有显著增高,且CVS患者的TIMP-1蛋白表达时间与非CVS患者有差异,同时检测患者血清MMP-9和TIMP-1的蛋白表达量对预测SAH后CVS的发生具有指导意义。

Objective To investigate the serum matrix metalloproteinase-9（MMP-9） and tissue inhibitor of matrix metalloproteinase-1（TIMP-1） as the predictor of cerebral vasospasm（CVS） after subarachnoid hemorrhage（SAH）.Methods 32 cases of subarachnoid hemorrhage patients were collected as the experimental group,another 20 healthy patients were collected as the control group.Blood was collected before surgery and on the first,third,the 7th and the discharge day,and the levels of MMP-9 and TIMP-1 in serum were tested by ELISA.Results In both CVS and non-CVS patients,serum MMP-9 was significantly higher than the control group at each time points of post-operation,and on the third and the 7th days of post-operation,serum MMP-9 increased more significantly in patients with CVS.In non-CVS patients,on the third and the 7th days of post- operation,serum TIMP-1 significantly increased,while in CVS patients,TIMP-1 increased on the third day after SAH,but it tended to return to the normal on the 7th day.Conclusion The difference of temporal expression of MMP-9 and TIMP-1 in serum of SAH patients may be a potential predictor of CVS.