干预基质金属蛋白酶-9对高血压脑出血后期脑水肿治疗的影响

 目的 探究基质金属蛋白酶-9(MMP-9)对高血压脑出血(hypertensive cerebral hemorrhage,HCH)患者后期脑水肿形成及治疗方案的影响。方法 纳入2014-06至2016-05医院神经外科住院HCH患者112例,随机分为两组,常规治疗联合MMP-9抑制药(实验组),常规治疗(对照组),每组56例。对比治疗2周后两组脑部水肿体积的变化、MMP-9值、神经功能缺损的评分(简称为NIHSS评分)以及治疗有效率。结果 实验组脑部水肿的体积(5.8±3.1)cm³、MMP-9值(61.3±21.9)μg/L及NIHSS评分(7.1±3.7)分,对照组脑部水肿的体积(12.5±3.4)cm³、MMP-9值(98.2±25.4)μg/L及NIHSS评分(13.2±4.3)分,两者之间的差异是存在着统计学意义的(P＜0.01),同时实验组有效率明显高于对照组(85.71% vs 64.29%,P＜0.01)。结论 对于HCH后期脑水肿给予常规化的治疗联合MMP-9抑制药可以提高临床治疗效果,提示MMP-9可能促进脑出血后期脑水肿的形成。

Impact of MMP-9 intervention on cerebral edema after cerebral hemorrhage

Objective To explore the impact of MMP-9 on cerebral edema formation in the late stage of hypertensive cerebral hemorrhage (HCH) and on clinical treatment.Methods The clinical data on 112 patients treated at the Department of Cerebral Surgery of our hospital between June 2014 and May 2016 was reviewed.Among these patients, 56 were treated with +MMP inhibitors(the experimental group) and the rest received routine treatment(the control group). Changes of the cerebral edema volume、MMP-9、neurological deficit score (NIHSS) and the total efficacy rate of treatment were compared between the two groups after two weeks of treatment.Results After two weeks of treatment, the volume of brain edema in the experimental group was (5.8±3.1) cm³, MMP-9 (61.3±21.9) μg/l and NIHSS score was (7.1±3.7), compared with (12.5±3.4) cm³, (98.2±25.4) μg/l and (13.2±4.3) respectively in the control group, so the difference was statistically significant (P<0.01 ). Moreover,the experimental group had a higher total efficacy rate than the control group (85.71%vs 64.29%,P＜0.01).Conclusions Conventional treatment comnbined with MMP-9 can improve the clinical efficacy in the late stage of HCH brain edema patients, which indirectly suggests that MMP-9 can promote the formation of cerebral edema in the late stage of cerebral hemorrhage.