急性缺血性脑卒中患者血清TIMP-1 HIF-1α水平与梗死灶体积及病情严重程度的关系

Relationship of serum TIMP-1 and HIF-1αlevels with cerebral infarction volume anddisease severity in patients with acute ischemic stroke

目的探讨急性缺血性脑卒中(AIS)患者血清缺氧诱导因子-1α(HIF-1α)、组织基质金属蛋白酶抑制剂-1(TIMP-1)水平与梗死灶体积及病情严重程度的关系。方法对168例AIS患者(研究组)和97名健康体检者(对照组)的临床资料进行回顾性分析。比较两组受试者基线资料、及血清TIMP-1、HIF-1α水平。分析AIS患者血清TIMP-1、HIF-1α水平与血压、血脂和血清hs-CRP、Hcy水平的相关性;比较不同梗死灶体积、病情严重程度AIS患者血清TIMP-1、HIF-1α水平;采用Spearman相关性分析探讨AIS患者发病1 d血清TIMP-1、HIF-1α水平与梗死灶体积及病情严重程度的相关性。结果研究组受试者收缩压、舒张压及总胆固醇、三酰甘油、超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、TIMP-1、HIF-1α水平均高于对照组(P<0.01),高密度脂蛋白胆固醇水平低于对照组(P<0.01)。AIS患者血清TIMP-1与hs-CRP、Hcy水平呈显著正相关(P<0.01),血清HIF-1α与三酰甘油水平呈显著负相关(P<0.01)。随着发病时间延长,不同梗死灶体积、不同病情严重程度AIS患者血清TIMP-1、HIF-1α水平逐渐降低,不同梗死灶体积、不同病情严重程度患者两两比较,差异均有统计学意义(P<0.01);随着梗死灶体积增加、病情严重程度的加重,AIS患者血清TIMP-1、HIF-1α水平逐渐升高,不同梗死灶体积、不同病情严重程度患者两两比较,差异均有统计学意义(P<0.01)。发病1 d,AIS患者血清TIM P-1、HIF-1α水平与梗死灶体积、NIHSS评分均呈显著正相关(P<0.01)。结论AIS患者血清TIMP-1、HIF-1α水平随着发病时间延长不断升高,且与梗死灶体积及病情严重程度有关,可作为早期诊断AIS的血清生化标志物和治疗新靶点,临床应用价值高。

Objective To explore the relationship of serum hypoxia inducible factor 1α(HIF-1α)and tissue inhibitor of metalloproteinase-1(TIMP-1)levels with cerebral infarction volume and disease severity in patients with acute ischemic stroke(AIS).Methods The clinical data of 168 AIS patients(research group)and 97 healthy examinees(control group)were retrospectively analyzed.Baseline data and serum TIMP-1 and HIF-1αlevels were compared between two groups.The correlations of serum TIMP-1 and HIF-1αlevels of AIS patients with blood pressures and blood lipids as well as serum hs-CRP and Hcy levels were analyzed;serum TIMP-1 and HIF-1αlevels were compared among AIS patients with different infarct volumes and severity;the correlations of serum TIMP-1 and HIF-1αlevels with infarct volume and severity were explored using Spearman correlation analysis on day 1of onset.Results Such indexes as systolic blood pressure,diastolic blood pressure,total cholesterol,triacylglycerol,hypersensitivity C-reactive protein(hs-CRP),homocysteine(Hcy),TIMP-1,and HIF-1αlevels were higher(P<0.01)and high density lipoprotein cholesterol(HDL-C)lower in research than control group(P<0.01).Serum TIMP-1 was significantly positively related to hs-CRP and Hcy levels(P<0.01)and serum HIF-1αnegatively to triacylglycerol(P<0.01)in AIS patients.With the prolongation of onset time serum TIMP-1 and HIF-1αlevels of AIS patients with different infarct volumes and severities of illness lowered gradually and differences in pairwise comparisons of patients with different infarct volumes and severities of illness were statistically significant(P<0.01);with the increase of infarct volume and the aggravation of illness severity serum TIMP-1 and HIF-1αlevels of AIS patients elevated gradually and differences in pairwise comparisons of patients with different infarct volumes and severities of illness were statistically significant(P<0.01).Serum TIMP-1 and HIF-1αlevels of AIS patients were significantly positively related to infarct volumes and NIHSS score on day 1 of onset(P<0.01).Conclusion Serum TIMP-1 and HIF-1αlevels in AIS patients gradually elevate with the prolongation of onset time and are related to infarct volume and disease severity,as can be used as a serum biochemical marker and a new therapeutic target for early diagnosis of AIS patients,with high clinical application value.