基质金属蛋白酶在脑出血发生发展中的作用及脑出血治疗预后分析

摘要

目的 探讨基质金属蛋白酶-2(MMP-2)和基质金属蛋白-9(MMP-9)在脑出血发生发展中的作用,并分析脑出血预后的影响因素.方法 选取50例脑出血患者作为脑出血组,体检者50例作为正常对照组,应用ELISA方法 测定患者发病后各时间段的血清MMP-2和MMP-9含量,同时监测患者脑血肿、水肿体积,美国国立卫生研究院卒中评分量表(NIHSS)评分评定患者神经功能缺损情况,并对预后的可能因素进行分析.结果 与正常组相比,脑出血组患者出血后1、3、7、14 d点的MMP-2和MMP-9含量均明显增高(P<0鬃.05);发病后7 d和14 d时MMP-9的含量与脑水肿体积呈正相关(r值分别为0.079、0.220,P<0.05);脑血肿量、手术时机与脑出血患者的近期预后相关(P<0.05),手术时机与远期预后相关(P<0.05).结论 MMP-9的过表达与脑出血后的水肿形成密切相关,脑血肿体积、手术时机可作为预测脑出血患者预后的因素.%Objective To investigate the role of matrix metalloproteinases (MMP-2 and MMP-9) in the pathogenesis and development of cerebral hemorrhage ,and to analyze the influencing factors on prognosis of cerebral hemorrhage .Methods Fifty patients with cerebral hemorrhage were served as cerebral hemorrhage group ,and 50 healthy subjects were served as control group .The levels of MMP-2 and MMP-9 in different time points after disease attack were detected by ELISA , meanwhile, patient' s cerebral hematoma and cerebral edema volume were observed , and neurologic impairment status was evaluated according to NIHSS score,moreover,the possible influencing factors on patient 's prognosis were analyzed.Results As compared with those in control group , the levels of MMP-2 and MMP-9 in cerebral hemorrhage group were significantly increased on 1d,3d,7d,14d after cerebral hemorrhage ( P <0.05).The levels of MMP-9 on 7d,14d after cerebral hemorrhage were positively correlated to cerebral edema volume ( r =0.079, 0.220, respectively, P <0.05).Moreover the cerebral edema volume and surgery opportunity were closely correlated to short -term prognosis of patients ( P <0.05 ) , besides, surgery opportunity was closely related with long-term prognosis of patients ( P <0.05 ) .Conclusion The over-expression of MMP-9 is closely related with the formation of edema after cerebral hemorrhage ,and cerebral edema volume and surgery opportunity can be regarded as the indexes to predict the prognosis of patients with cerebral hemorrhage .