缺血性脑卒中患者血浆基质金属蛋白酶-9和基质金属蛋白酶抑制剂-1水平的变化

目的探讨缺血性脑卒中患者治疗前后血浆基质金属蛋白酶-9(MMP-9)和基质金属蛋白酶抑制剂-1(TIMP-1)水平的变化。方法选择50例缺血性脑卒中患者(观察组),予以控制颅内压、降血压和血糖、抗血小板聚集、改善脑局部微循环等常规对症支持治疗,连用两周。观察患者治疗前后血浆MMP-9和TIMP-1水平的变化,并进行临床疗效评定。另选择同期我院体检中心的健康体检者30例作为对照组。结果观察组患者治疗前血浆MMP-9和TIMP-1水平明显高于对照组(P均<0.01)。治疗1、2周后,观察组患者血浆MMP-9和TIMP-1水平较治疗前明显下降(P<0.05)。观察组脑卒中灶大面积组MMP-9和TIMP-1水平明显高于小面积组(t=2.24、2.41,P均<0.05)。同时观察组治疗1、2周后,脑卒中灶面积均较治疗前逐渐缩小(P均<0.05),治疗两周后痊愈21例,显著进步13例,进步9例,无效7例,临床总有效率为86.0%。结论缺血性脑卒中患者存在血浆MMP-9及其抑制剂TIMP-1异常升高,其水平与脑卒中灶面积呈正相关,血浆MMP-9和TIMP-1水平可作为缺血性脑卒中患者治疗疗效随访的指标。通过调节MMP-9和TIMP-1水平,可为缺血性脑卒中防治提供一种新的方法。

Changes of plasma matrix metalloproteinase 9 and matrix metalloproteinase inhibitor-1 levels in patients with ischemic stroke

Objective To investigate the changes of plasma matrix metalloproteinase-9 （MMP-9） and matrix metallopro teinase inhibitor-1 （TIMP-1） levels in patients with ischemic stroke before and after therapy. Methods A total of 50 cas- es of patients with ischemic stroke（observation group） were given conventional symptomatic and supportive treatment such as control of intracranial pressure, lowering blood pressure and blood glucose, anti-platelet aggregation,improving regional cerebral microcirculation for two weeks. The changes of plasma MMP-9 and TIMP-1 levels in observation group of patients before and after therapy were observed, and clinical efficacy was assessed. Another 30 healthy persons of the same period in hospital medical center were chosen as control group. Results The plasma MMP-9 and TIMP-1 levels in observation group before treatment were significantly higher （P 〈 0.01） than those in control group. After one or two weeks of treatment, the plasma MMP-9 and TIMP-I levels decreased significantly（P 〈 0.05）. Stroke lesion volume decreased significantly af- ter treatment for one or two weeks in observation group （P 〈 0.05） ;two weeks after therapy resuhed in recovery in 21 cases, significant progress in 13 cases, progress in 9 cases and no effect in 7 cases with the total efficiency of 86.0%. Conclusion There are abnormal elevation of plasma MMP-9 and its inhibitor TIMP-1 in the patients with ischemic stroke,plasma MMP-9 and TIMP-1 levels can be used as indicators of treatment efficacy follow-up of patients with ischemic stroke. By regulating MMP-9 and TIMP-1 levels provide a new approach for the prevention and treatment of ischemic stroke.