缺血型和出血型成年烟雾病患者MMP与VEGF的表达水平差异及其与病情程度的关系

摘要

目的 探讨缺血型和出血型成年烟雾病患者MMP与VEGF的表达水平差异及其与病情程度的关系.方法 选取2014年1月-2017年1月于本院治疗的80例烟雾病患者,其中出血型34例,缺血型46例, 同时选取同期在本院进行体检健康的60例患者,比较3组患者的血清MMP-9及VEGF水平;比较出血型和缺血型烟雾病患者Suzuki分级中血清VEGF和MMP-9水平;根据病情进程,将患者分为好转组和非好转组,比较2组患者发病后第3d及第15 d的血清VEGF和MMP-9水平.结果 出血型和缺血型烟雾病患者的血清VEGF和MMP-9水平均高于对照组(P＜0.05),但两者之间的VEGF和MMP-9水平无明显差异(P＞0.05);随着Suzuki分级的增加,2组患者的VEGF和MMP-9水平也相应增加,且有明显差异(P＜ 0.05);好转组患者入院后第3 d和第15 d的血清VEGF和MMP-9水平均低于非好转组(P＜0.05).结论 血清MMP与VEGF水平在缺血型和出血型成年烟雾病患者中呈高表达,且与病情严重程度有关.%Objective To investigate the correlation between expression levels of MMP and VEGF in patients with ischemic and hemorrhagic adult moyamoya disease (MMD) and severity. Methods 80 patients with MMD from January 2014 to January 2017 were divided into hemorrhagic adult moyamoya disease group(n=34) and ischemic adult moyamoya disease group(n =46), and 60 health adult were selected in physical examination as control group. The serum MMP-9 and VEGF were compared between the three groups. Serum levels of VEGF and MMP-9 in Suzuki grades were compared between hemorrhagic and ischemic MMD patients. According to the progression of the disease, the patients were divided into the optimal group and the non-optimal group, and the levels of serum VEGF and MMP-9 were compared between the 3rd day and the 15th day after the onset of the two groups. Results The levels of serum VEGF and MMP-9 in hemorrhagic and ischemic MMD patients were significantly higher than those in healthy controls (P＜0.05), but there was no significant difference in VEGF and MMP-9 between the hemorrhagic and ischemic MMD groups (P＞0.05). With the increase of Suzuki classification, the serum of VEGF and MMP-9 in the two groups were also increased, the difference was statistically significant (P＜0.05). The levels of serum VEGF and MMP-9 in the optimal group at the 3rd day and the 15th day were significantly lower than those in the non-optimal group (P＜0.05). Conclusion Serum MMP and VEGF were highly expressed in ischemic and hemorrhagic MMD patients, and were positively correlated with the severity of the disease. MMP and VEGF levels were helpful for early diagnosis and disease prediction of ischemic and hemorrhagic MMD.