脑卒中患者血浆Hcy MMP-9和ApoE水平与头颅SWI影像学特征的相关性

Correlation of Plasma Hcy,MMP-9 and ApoE Levels with Brain SWI Imaging Features in Patients with Stroke

目的:探讨脑卒中患者血浆同型半胱氨酸(Hcy)、血清基质金属蛋白酶-9(MMP-9)和载脂蛋白(ApoE)水平与头颅磁敏感加权成像(SWI)影像学特征的相关性。方法:选取2017年1月至2019年1月份本院收治的脑卒中患者96例为观察组,另选取同期健康人员44例作为对照组,行头颅SWI影像检测与血清Hcy、MMP-9和ApoE的表达水平检测,比较两组梗死灶数量与Hcy、MMP-9和ApoE水平等相关情况。结果:SWI-MRI检查结果,SWI序列敏感度显著高于DWI、T1WI、T2WI序列(P<0.05);观察组患者血清Hcy、ApoE与MMP-9表达水平均显著高于对照组(P<0.05);大梗死灶患者血清Hcy、ApoE与MMP-9表达水平均显著高于中梗死灶与小梗死灶患者(P<0.05);观察组患者血清Hcy、MMP-9、ApoE表达水平与脑卒中病灶数量、病灶体积、脑皮质病灶数量呈正相关性(P<0.05),ApoE表达水平与深部白质病灶数量呈正相关性(P<0.05);logistics回归分析显示,血浆Hcy、MMP-9、ApoE水平与SWI影像学诊断结果具有显著相关性(P<0.05)。结论:Hcy、MMP-9、ApoE表达水平与SWI影像学结果中脑卒中病灶数量、病灶体积、皮质层病灶呈正相关性,ApoE表达水平与白质层病灶呈正相关性,Hcy、MMP-9、ApoE表达水平对脑卒中病情发展的独立危险因素。

Objective:To explore the correlation between plasma homocysteine(Hcy),serum matrix metalloproteinase-9(MMP-9)and apolipoprotein(ApoE)levels and head susceptibility-weighted imaging(SWI)features in stroke patients.Methods:96 stroke patients admitted to the hospital between January 2017 and January 2019 were selected as the observation group.Meanwhile,44 healthy people were selected as the control group.Head SWI examination and plasma Hcy,MMP-9 and ApoE detection were performed.The number and location of bleeding displayed by head SWI images,Hcy,MMP-9 and ApoE levels were compared between the two groups.Results:The SWI-MRI examination results showed that the sensitivity of SWI sequence was significantly higher than that of DWI,T1WI and T2WI(P<0.05).Plasma Hcy,ApoE and MMP-9 levels were significantly higher in observation group than control group(P<0.05),and significantly higher in patients with large infarction than those with middle and small infarction(P<0.05).In the observation group,plasma Hcy,MMP-9 and ApoE levels were positively correlated with the number and volume of stroke lesions and the number of cerebral cortical lesions(P<0.05).The expression level of ApoE was positively correlated with the number of deep white matter lesions(P<0.05).Logistics regression analysis showed that plasma Hcy,MMP-9 and ApoE levels were significantly correlated with the diagnostic results of SWI(P<0.05).Conclusion:The expression levels of Hcy,MMP-9 and ApoE are positively correlated with the number and volume of stroke lesions and cortical lesions displayed by SWI.The expression level of ApoE is positively correlated with white matter lesions.Hcy,MMP-9 and ApoE levels are independent risk factors of stroke development.