MMP-9血清水平及启动子C-1562T基因与缺血性脑卒中侧支循环的关系

Association between MMP-9 Serum Level,Gene Promoter C-1562T Polymorphism and Collateral Circulation in Ischemic Stroke

目的探讨基质金属蛋白酶-9(MMP-9)血清水平及基因启动子C-1562T多态性与缺血性脑卒中侧支循环的关系。方法选取我院神经科住院的急性缺血性脑卒中患者,收集患者一般临床资料。侧支循环的开放途径分为三级,血流分级采用美国介入治疗神经放射学学会/介入放射学学会(ASITN/SIR)评估系统,采用ELISA法测定MMP-9血清水平,采用聚合酶链反应限制性片段长度多态性(PCR-EFLP)测定MMP-9基因启动子C-1562T位点C/T的基因多态性。结果共纳入符合标准患者292例,其中男167例,女125例。年龄31~86岁,平均(61.43±10.07)岁。MMP-9血清水平及MMP-9基因启动子C-1562T多态性与侧支循环ASITN/SIR血流分级之间差异无统计学意义(P>0.05)。不同侧支循环途径间MMP-9血清水平差异有统计学意义(P<0.05)。Bonferroni校正后三级侧支循环MMP-9血清水平仍明显高于一级侧支循环MMP-9血清水平和二级侧支循环MMP-9血清水平,差异有统计学意义(P<0.01)。结论 MMP-9血清水平可能对急性缺血性脑卒中患者脑侧支循环代偿途径的预测有一定的作用,对患者个体化治疗和预后的评价起到一定的指导作用。

Objective To investigate the relationship between MMP-9 serum level,gene promoter C-1562 T polymorphism and collateral circulation in ischemic stroke. Methods The general clinical data of patients with acute ischemic stroke who were hospitalized in our hospital were selected. The open pathway of collateral circulation was divided into three stages. The blood flow grading was performed using ASITN/SIR evaluation system. The level of MMP-9 was determined by ELISA and the gene polymorphism of MMP-9 gene promoter C-1562 T was determined by PCR-EFLP. Results A total of 292 patients were included,including 167 males and 125 females. The age ranged from 31 to 86 yr,average age was（ 61. 43 ± 10. 07 yr）.There were no statistical difference between MMP-9 serum level,MMP-9 gene promoter C-1562 T polymorphism and lateral branch circulation ASITN/SIR blood flow classification（ P 0. 05）. There was significant difference in MMP-9 serum level between different collateral pathways（ P 0. 05）. After Bonferroni correction,this relationship still existed. The serum level of MMP-9 in the third-stage collateral circulation was significantly higher than that in the first-stage collateral circulation（ P 0. 001） and in the secondary-stage collateral circulation（ P 0. 01）. Conclusions The serum level of MMP-9 may play a role in predicting the compensatory pathway of cerebral collateral circulation in patients with acute ischemic stroke,and may play a guiding role in the evaluation of individualized treatment and prognosis.