急性脑梗死患者血清基质金属蛋白酶-9动态变化及临床意义

目的研究急性脑梗死患者血清基质金属蛋白酶-9（MMP-9）水平的变化及临床价值。方法选取临床确诊的80例急性脑梗死病例及同期同年龄纽体检健康者60例。用酶联免疫吸附法（ELISA）测定发病后1、2、5、7、14d血清MMP-9的浓度，与健康组比较。结果患者组MMP-9血清浓度发病后1、2、5、7、14d分别是（272±128）μg／L、（395±157）μg/L、（378±140）μg／L、（307±127）μg／L、（236±112）μg／L，与对照纽（149±110）μg／L相比差异有统计学意义（P〈0．01），以发病后2d水平升高明显，后持续5d左右；并且大梗死组血清MMP-9水平明显高于中和小梗死组，血清MMP-9水平与脑梗死体积和预后之间存在相关性（P〈0．01）。结论急性脑梗死患者发病早期血清MMP-9水平明显增高，且其增高程度能够为中枢神经系统受损程度提供定量信息，为病情的严重程度和预后有预示作用。

Dynamic change of serum MMP - 9 in patients with acute cerebral infarction and clinical significance

Objective To investigate the changes of matrix metalloproteinase- 9 （MMP- 9）concentration in patients with acute cerebral infarction（ACI） and to evaluate its clinical significance. Methods 80 cases of ACI and 60 normal were included in the study. The blood samples were collected at days 1,2,5,7 and 14 after stroke onset. Serum MMP -9 levels were detected by enzyme -linked immunosorbent assay（ELISA）. 60 healthy persons were used as control subjects. Results The serum MMP -9 levels in ACI patients were （272 ± 128） μg/L, （395 ± 157） μg/L, （378 ± 140） μg/L, （307 ± 127） μg/L, （236 ± 112）μg/L respectively at 1 d,2 d,5 d,7 d,14 d after the onset. The above serum MMP -9 level were higher than the normal group, merely（ 149 ± 110）μg/L （ P 〈 0.01 ,respectively）. MMP -9 level in the large infaction group was higher than in the medium or the small infaction group at 2 day after stroke onset（ F = 24. 298 ,P 〈0. O1 ）. The infarction size and prognosis were correlated with serum MMP - 9 levels prognosis （ P 〈 0.01 ）. Conclusions The MMP - 9 level remarkably increased in the early stage of patients with ACI, and the increasing degree may provide quantitative information for the damage of central nervous systerm, and the serum level of MMP- 9 might have prognostic value to the cerebral ischemia.