水通道蛋白4和基质金属蛋白酶-9水平预测脑梗死患者发生恶性脑梗死的价值

Value of aquaporin 4 and matrix metalloproteinase-9 levels in predicting malignant cerebral infarction in patients with cerebral infarction

目的探讨血清水通道蛋白4(AQP4)和基质金属蛋白酶-9(MMP-9)水平预测脑梗死患者发生恶性脑梗死的价值。方法选取大脑半球大面积脑梗死患者66例,收集临床资料,根据临床症状及脑CT检查结果将患者分为恶性脑梗死(MCI)组和非MCI组,检测入院第1、4、7天血清AQP4和MMP-9水平,利用受试者工作特征曲线(ROC)分析血清AQP4和MMP-9水平预测发生MCI的价值。结果MCI组患者在第4天抽取的血样中,AQP4和MMP-9水平均高于非MCI组患者,差异均有统计学意义(P<0.05)。同时在MCI组患者中,第4天血清AQP4、MMP-9水平明显高于第1天及第7天水平,差异均有统计学意义(P<0.05)。在非MCI组患者中,AQP4、MMP-9三个时间点前后测量比较差异无统计学意义(P>0.05)。ROC曲线分析显示,血清AQP4水平预测发生MCI的曲线下面积为0.654(95%CI:0.516~0.792),当血清AQP4=23.49μg/L时,灵敏度为0.57,特异度为0.74。结论MCI患者血清AQP4和MMP-9水平升高,联合检测血清AQP4和MMP-9有助于早期鉴别诊断MCI。

Objective To investigate the diagnostic value of serum levels of aquaporin-4(AQP4 and matrix metalloproteinase-9(MMP-9)in predicting malignant cerebral infarction in patients with cerebral infarction.Methods The clinical data about 66 patients with hemisphere massive cerebral infarction were collected.According to clinical symptoms and brain computed tomography(CT)findings,the patients were divided into malignant cerebral infarction group(MCI)and non-MCI group.The serum levels of AQP4 and MMP-9 were detected 1,4,7 days.The diagnostic value of AQP4 and MMP-9 in predicting occurrence of MCI was analysed by receiver operating characteristic(ROC)curve.Results The serum levels of AQP4 and MMP-9 in MCI group were significantly higher than those in non-MCI group in the fourth day(P<0.05).In MCI group,AQP4 and MMP-9 in the fourth day were significant higher than other two time points(P<0.05).But in non-MCI group,AQP4 and MMP-9 in different time points have no differences(P>0.05).ROC curve analysis showed that the aera under curve for the serum levels of AQP4 was 0.654(95%CI:0.516-0.792).When the serum AQP4=23.49μg/L,the sensitivity and specificity were0.57,0.74,respectively.Conclusions Serum AQP4 and MMP-9 levels were increased in patients with MCI.Combined detection of serum AQP4 and MMP-9 is helpful for early differential diagnosis of MCI.