前、后循环急性脑梗死患者血清MMP-9的浓度变化及临床意义

Changes and Clinical Significance of Serum MMP-9 Concentration in Patients with Acute Cerebral Infarction in Anterior and Posterior Circulation

目的:探究前、后循环急性脑梗死患者血清基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)的浓度变化及其与病情程度的相关性。方法:回顾性研究2013年1月-2018年7月上海市宝山区仁和医院神经内科收治的88例急性脑梗死患者,前循环梗死46例,后循环梗死42例,同时根据患者预后结局分为死亡组(n=35)和存活组(n=53),同期选50例健康人员作为对照组。采用ELISA法检测MMP-9水平,并收集患者基线资料进行统计学分析。结果:脑梗死组MMP-9水平显著高于对照组,差异有统计学意义(P<0.05);前循环组血清MMP-9水平明显低于后循环组,差异有统计学意义(P<0.05);前循环组美国国立卫生研究院卒中量表(NIHSS)为(12.29±2.26)分,低于后循环组的(19.38±4.32)分,差异有统计学意义(P<0.05),且前循环组和后循环组NIHSS评分与血清MMP-9均呈正相关(r=0.651、0.591,P<0.001);死亡组吸烟史、饮酒史、脂代谢紊乱、脑动脉狭窄、后循环急性脑梗死比例均明显高于存活组,MMP-9水平低于存活组,白细胞计数(WBC)、超敏C反应蛋白(hs-CRP)水平均高于存活组(P<0.05);MMP-9、hs-CRP、WBC、后循环急性脑梗死、脂代谢紊乱、饮酒史、脑动脉狭窄均为影响患者预后的独立危险因素(P<0.05)。结论:急性脑梗死患者MMP-9水平显著升高,与NIHSS评分呈正相关,后循环急性脑梗死患者血清MMP-9水平高于前循环急性脑梗死患者,且MMP-9水平是预后的影响因素。

Objective:To explore the changes of serum matrix metalloproteinase-9(MMP-9)concentration in patients with acute cerebral infarction in anterior and posterior circulation and its correlation with the severity of the disease.Method:A retrospective study was conducted in 88 patients with acute cerebral infarction who were admitted to the Department of Neurology,Shanghai Baoshan District Renhe Hospital from January 2013 to July 2018.There were 46 cases with anterior circulation infarction and 42 cases with posterior circulation infarction.According to the prognosis of the patients,they were divided into a death group(n=35)and a survival group(n=53).Meanwhile,50 healthy people were selected as the control group.The level of MMP-9 was detected by ELISA,and the baseline data of patients were collected for statistical analysis.Result:The level of MMP-9 in cerebral infarction group was significantly higher than that in control group(P<0.05).The serum MMP-9 level in the anterior circulation group was significantly lower than that in the posterior circulation group,the difference was statistically significant(P<0.05).The NIHSS score in the anterior circulation group was(12.29±2.26),which was lower than(19.38±4.32)in the posterior circulation group,the difference was statistically significant(P<0.05).The NIHSS scores in the anterior circulation group and posterior circalation group were positive correlated with serum MMP-9(r=0.651,0.591,P<0.001).The proportion of smoking,drinking,lipid metabolism disorder,cerebral artery stenosis and posterior circulation acute cerebral infarction in the death group were significantly higher than those in the survival group,the level of MMP-9 was lower than that in the survival group,and the levels of WBC and hs-CRP were higher than those in the survival group(P<0.05).MMP-9,hs-CRP,WBC,acute cerebral infarction in posterior circulation,lipid metabolism disorder,drinking history and cerebral artery stenosis were all independent risk factors that affect the prognosis of patients(P<0.05).Conclusion:The level of MMP-9 in patients with acute cerebral infarction is significantly increased,which is positive correlated with the NIHSS scores.The level of serum MMP-9 in patients with acute cerebral infarction in posterior circulation is higher than that in patients with acute cerebral infarction in anterior circulation,and the level of MMP-9 is a prognostic factor.