血清UA、MMP-9水平与脑小血管病患者脑白质高信号的关系

Relationship between serum UA and MMP-9 levels and white matter hyperintensities in patients with cerebral small vascular disease

目的探讨血清尿酸(UA)、基质金属蛋白酶-9(MMP-9)水平与脑小血管病(CSVD)患者脑白质高信号(WMH)的关系。方法选取2020年1月至2022年12月陕西省中医医院收治的WMH患者68例,根据Fazekas评分将WMH组又分为轻度组(30例)、中度组(23例)和重度组(15例),另选取同期57例健康体检者为对照组。统计各组患者临床基础资料及血清UA、MMP-9水平,分析血清UA、MMP-9对WMH的诊断价值。结果与对照组相比,WMH组患者年龄偏大,高血压史比例高(P<0.05);WMH组外周血Hcy、UA及MMP-9水平高于对照组(P<0.05)。中度组和重度组血清UA、MMP-9水平明显高于轻度组(P<0.05),重度组血清UA、MMP-9水平又高于中度组(P<0.05)。WMH组患者血清UA、MMP-9水平与Fazekas评分呈显著正相关(P<0.05)。Logistic回归分析显示,年龄偏大、高血压、血清UA及MMP-9水平升高是CSVD WMH发生的危险因素(P<0.05)。UA联合MMP-9诊断WMH的曲线下面积(AUC)为0.919(95%CI为0.873~0.965),敏感度为88.2%,特异度为82.6%。结论血清UA、MMP-9水平与CSVDWMH的发生及病变程度密切相关,两者可作为评估WMH病情发展的重要指标。

Objective To investigate the relationship between serum uric acid(UA)and matrix metalloproteinase-9(MMP-9)levels and white matter hyperintensities(WMH)in patients with cerebral small vascular disease CSVD.Methods A total of 68 patients with WMH admitted to Shaanxi provincial hospital of traditional chinese medicine from January 2020 to December 2022 were selected.The WMH group was divided into mild group(30 cases),moderate group(23 cases)and severe group(15 cases)according to Fazekas score,and 57 healthy subjects were selected as control group during the same period.The clinical basic data and blood UA and MMP-9 levels of patients in each group were analyzed,and the diagnostic value of serum UA and MMP-9 in WMH was analyzed.Results Compared with control group,WMH group was older and the proportion of hypertension history was higher(P<0.05).The levels of Hcy,UA and MMP-9 in peripheral blood of WMH group were higher than those of control group(P<0.05).The levels of serum UA and MMP-9 in moderate and severe groups were significantly higher than those in mild group(P<0.05),and the levels of serum UA and MMP-9 in severe group were higher than those in moderate group(P<0.05).The levels of serum UA and MMP-9 in WMH group were significantly positively correlated with Fazekas scores(P<0.05).Logistic regression analysis showed that older age,hypertension,elevated serum UA and MMP-9 levels were risk factors for WMH(P<0.05).The area under the curve(AUC)of UA combined with MMP-9 for the diagnosis of WMH was 0.919(95%CI:0.873 to 0.965),sensitivity was 88.2%,and specificity was 82.6%.Conclusion The levels of serum UA and MMP-9 are closely related to the occurrence and lesion degree of WMH,and they can be used as important indicators to evaluate the progression of WMH.