急性脑梗死患者静脉溶栓后血清EPO,MMP-9水平与短期预后的相关性研究

目的 分析急性脑梗死(Acute cerebral infarct,ACI)患者静脉溶栓后血清促红细胞生成素(Erythropoietin,EPO)、基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)水平与短期预后的相关性。方法 选取本院2018年10月-2020年3月收治93例ACI患者,入院后均予以静脉溶栓治疗; 于治疗结束后进行30 d的随访,应用改良Rankin量表(Modified Rankin scale,mRS)评估预后并分组,且检测血清EPO,MMP-9水平; 分析血清EPO,MMP-9水平与ACI患者静脉溶栓后短期预后的相关性。结果 93例ACI患者随访30 d后血清EPO,MMP-9水平均较治疗前降低(P<0.05); 随访结束93例患者不良预后有32例,经单因素、多因素分析显示血清白蛋白低表达、EPO与MMP-9过度表达可能是ACI患者静脉溶栓后短期预后不良的影响因素(OR>1,P<0.05),其中EPO,MMP-9低表达带来的影响较显著,可能作为独立危险因素(OR=1.096～2.129); 经相关性检验显示ACI患者血清EPO与MMP-9水平呈正相关(r=0.370,P<0.05); 绘制ROC曲线发现,静脉溶栓治疗前血清EPO,MMP-9水平预测ACI患者短期预后不良风险的曲线下面积(AUC)均>0.85,有一定预测价值。结论 血清EPO,MMP-9过度表达可能提示ACI患者静脉溶栓后短期预后不良,监测二者水平变化可为ACI患者静脉溶栓后预后不良的早期预测、干预提供依据。

The correlation between serum EPO and MMP-9 levels and short-term prognosis after intravenous thrombolysis in patients with acute cerebral infarction

ObjectiveTo analyze the correlation between serum erythropoietin(EPO)and matrix metalloproteinase-9(MMP-9)levels and short-term prognosis after intravenous thrombolysis in patients with acute cerebral infarction(ACI).Methods 93 patients with ACI treated in our hospital from October 2018 to March 2020 with intravenous thrombolytic therapy after admission, 30 d follow-up was performed after treatment, and the modified Rankin scale(mRS)was used to assess the prognosis and grouped. Serum EPO and MMP-9 levels were detected, the correlation between serum EPO and MMP-9 levels and short-term prognosis after intravenous thrombolytic therapy in ACI patients was analyzed.Results The serum EPO and MMP-9 levels of 93 ACI patients were decreased after 30 days of follow-up(P<0.05), after the follow-up, there were 32 patients with poor prognosis among 93 cases, the single factor and multifactor analysis showed that low expression of serum albumin, overexpression of EPO and MMP-9 might be the influencing factors of poor short-term prognosis after intravenous thrombolytic therapy in ACI patients(OR>1, P<0.05),among them the effects of low EPO and MMP-9 levels were more significant and might be used as independent risk factors(OR=2.129,1.096). The correlation test showed that the serum EPO and MMP-9 levels in ACI patients were positively correlated(r=0.370, P<0.05). The ROC curve found that the serum EPO and MMP-9 levels before intravenous thrombolytic therapy predicted that the area under the short-term prognostic adverse risk(AUC)of ACI patients was all> 0.85, which had certain predictive value.Conclusion The overexpression of serum EPO and MMP-9 might indicate the short-term prognostic risk of ACI patients after intravenous thrombolytic therapy. Monitoring the changes of the two parameter levels could provide the basis for early prediction and intervention of poor prognosis after intravenous thrombolytic therapy in ACI patients.