血肿抽吸术对脑出血后早期基质金属蛋白酶-9的影响

摘要

目的探讨血肿抽吸术治疗脑出血对患者血清基质金属蛋白酶-9水平的影响。方法选择脑出血患者60例的临床资料进行回顾性分析，其中30例采用血肿抽吸术治疗为研究组，30例采用保守治疗为对照组，比较2组治疗前后血清MMP-9水平，分析MMP-9与NDS的相关性，以及患者的预后情况。结果2组血清MMP-9水平均在治疗后2 d达到高峰，但研究组的高峰值显著低于对照组，差异有统计学意义（P＜0.01）；随后MMP-9水平逐渐下降，但研究组治疗后7 d及14 d MMP-9水平均显著低于对照组，差异有统计学意义（P＜0.01）。2组治疗后NDS评分均显著低于入院时，差异有统计学意义（P＜0.01）；研究组治疗第14天研究组NDS评分显著低于对照组，差异有统计学意义（P＜0.01）。研究组和对照组血清MMP-9水平与NDS评分具有显著的正相关性（P＜0.01）。研究组总有效率90.0％，对照组为63.3％，研究组显著高于对照组，差异有统计学意义（P＜0.05）。结论脑出血患者采用血肿抽吸术治疗，治疗后能够显著降低MMP-9的高峰值，有利于改善患者的预后。%Objective To explore the effect of hematoma aspiration on matrix metalloproteinase-9 (MMP-9) after in‐tracerebral hemorrhage. Methods Clinical data of 60 patients with intracerebral hemorrhage were collected and analyzed re‐spectively. 30 cases were treated with hematoma aspiration as study group ,another 30 cases of control group were treated with medications. MMP-9 levels of two groups before and after treatment were collected and compared ,relationships between MMP-9 and NDS (neurological functional defect scale score) as well as clinical efficacy were observed. Results MMP-9 levels in the serum of both groups reached the peaks after 2 days with treatments ,but the MMP-9 peak level of study group was sig‐nificantly lower than that of control group (P<0.01);However ,MMP-9 levels of both groups decreased ,but MMP-9 levels of study group were significantly lower than that of control group at the day 7 and day 14 following intracerebral hemorrhage (P<0.01). NDS scores in both groups after treatment were significantly lower than those before treatment (P<0.01) .After treatment ,NDS scores of study group were significantly lower than that of control group (P<0.01). MMP-9 levels in serum showed positive correlation with NDS (P< 0.01).Total efficacy rate of study group was 90.0% ,and control group was 63.3% ,which showed significant difference (P<0.05).Conclusion Hematoma aspiration for intracerebral hemorrhage can reduce MMP-9 peak level ,which may help to improve the prognosis of patients with intracerebral hemorrhage .