急性脑梗死患者MMP-9和VEGF的动态变化及其意义

目的 探讨急性脑梗死患者血清基质金属蛋白酶-9 （MMP-9）和血管内皮生长因子（VEGF）浓度的动态变化及其临床意义.方法 选取2009年6月至2012年6月河北大学附属医院神经内科收住院的首次发病48 h内的急性脑梗死患者106例（脑梗死组）及同期健康体检者50例（正常对照组）.分别于脑梗死发病后1、3、7、14 d时抽取静脉血测定脑梗死组血清MMP-9和VEGF浓度,并于7d测量梗死面积和评估预后,分析MMP-9和VEGF浓度与脑梗死面积大小及预后的关系.结果 两组比较,脑梗死组各时间点血清MMP-9和VEGF浓度显著增高（P＜0.01）,并呈现一定的动态变化规律.脑梗死组各时间点MMP-9和VEGF的浓度间无相关性（P＞0.05）.脑梗死发病7d时MMP-9和VEGF浓度均与脑梗死面积有一定相关性.脑梗死组中预后不良组血清MMP-9和VEGF浓度各时间点均显著高于预后良好组（P＜0.01）.结论 急性脑梗死患者血清MMP-9和VEGF浓度均显著增高,且血清MMP-9和VEGF的浓度与脑梗死面积大小及预后关系密切.

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

Objective To investigate the changes and clinical significance of sermn matrix metal proteinase-9 （MMP-9） and vascular endothelial growth factor （VEGF） in patients with acute cerebral infarction （ACI）. Methods One hundred and six ACI patients admitted to affiliated hospital of Hebei university from June 2009 to June 2012 were chosen as ACI groups, 50 healthy subjects as control. In ACI group, serum MMP-9 and VEGF levels were determined on the 1st, 3rd, 7th,14th day after onsets ,and the infarct size was measured and prognosis was evaluated on the 7th day after onsets, the relationship between MMP- 9, VEGF and infarction size and prognosis were analyzed. Results Serum MMP-9 and VEGF levels at varying time points in- creased significantly in ACI group as compared with controls （P 〈 0. 01 ） , showing dynamic changes. There was no correlation of MMP-9 with VEGF levels between different time points in group ACI （ P 〉 0. 05 ）. Serum MMP-9 and VEGF were correlated with infarction size. MMP-9 and VEGF were higher in patients with poor prognosis than those in patients with good prognosis at varyingtime points （ P 〈 0.01 ）. Conclusion Serum MMP-9 and VEGF levels increase significantly in ACI patients, and infarction size and prognosis are closely related to the levels of MMP-9 and VEGF.