急性脑梗死患者血清基质金属蛋白酶-9、C-反应蛋白临床意义的研究

目的研究缺血性脑卒中患者急性期血清基质金属蛋白酶-9(MMP-9)、C-反应蛋白(CRP)水平与脑梗死病灶体积大小以及预后的关系,并探讨其潜在的机制。方法对124例缺血性脑卒中患者在起病24h内抽取肘静脉血,用酶联免疫吸附测定法测定MMP-9水平,同时用免疫比浊法测定CRP水平。根据脑卒中患者临床神经功能缺损程度评分标准对患者入院以及入院3周后进行评分,患者均进行CT/MRI检查确诊。结果3组受检者MMP-9、CRP、三酰甘油及白细胞数间差别均有显著性意义(P<0.01);CRP异常组和正常组脑梗与腔梗构成比、病死率、治疗有效率、MMP-9水平间差别均有显著性意义(P<0.01),CRP异常患者中,高MMP-9组与非高MMP-9组脑梗与腔梗构成比、治疗有效率间差别均有显著性意义(P<0.05),病死率间差别无显著性意义(P>0.05)。MMP-9水平与CRP水平呈直线正相关(r=0.224,P=0.013),与预后呈等级正相关(r=0.180,P=0.046)。结论脑梗死急性期血清MMP-9、CRP水平与缺血性脑卒中有关,对于梗死体积大小以及近期预后的判断有一定的临床意义。

Clinical Significance of Matrix Metalloproteinases-9, C-Reaction Protein in Acute Cerebral Infarction

Objective To investigate the relation of matrix metalloproteinases-9 ( MMP-9 ) and C-reactive protein (CRP) concentrations with the size of cerebral infarction focus and the prognosis in cerebral ischemic stroke.Methods A total of 124 patients with acute cerebral ischemic stroke were enrolled.Serum MMP-9 and CRP levels were determined by enzyme-linked immunosorbent assay and immune turbidimetry respectively in blood samples obtained within 24 hours of ischemic stroke.All patients were scored by the assessment standard of clinical nervous functional defect degree (CNFD),and identified by computed topography and magnetic resonance imaging examination.Results Serum MMP-9,CRP and triglyceride levels,and leukocyte count at admission were significantly higher in the territory infarction group than those in the lacunar infarction group ( P <0.01).In the group of elevated CRP,serum MMP-9 level,mortality,component ratio of territory infarction and the lacunar infarction were higher; while the therapeutic efficacy was worse than those in normal CRP group( P <0.01).The component ratio of territory infarction was higher in high MMP-9 group than that in non-high MMP-9 group ( P <0.05) ; while the therapeutic efficacy was worse ( P >0.05).Correlation analysis showed that there were a linear positive correlation and a rank positive correlation between MMP-9 level and prognosis,and between MMP-9 and CRP levels ( r =0.180,P =0.046; r =0.224,P =0.013,respectively).Conclusion There may be a close relationship of MMP-9 and CRP levels with the cerebral infarction,which is of clinical significance to determine the infarct volume and its prognosis.