高压氧治疗对脑梗死患者血清基质金属蛋白酶-9的影响

目的探讨高压氧（HBO）治疗后急性脑梗死患者血清基质金属蛋白酶-9（MMP-9）水平的动态变化及其与临床疗效的关系。方法采用酶联免疫吸附双抗体夹心法测定脑梗死患者入院时、发病后第3、5、10天以及正常对照组血清MMP-9浓度。对所有患者于入院时和治疗后10d、1个月进行神经功能缺损评分,评价HBO组和常规组疗效差异。结果与正常对照组比较,HBO组和常规组入院时血清MMP-9的浓度均明显增高（P〈0.01）。与治疗前比较,常规治疗组和HBO治疗组血清MMP-9水平均呈现先增高后降低的动态变化趋势,3d时达高峰,于治疗后10d时降低至入院时的水平,但仍高于正常对照组（P〈0.01）,比较2组患者各时间点的MMP-9的浓度显示,在治疗后3、5d时HBO治疗组的血清MMP-9浓度低于同期常规治疗组（P〈0.05）;治疗1个月后神经功能缺失评分HBO组明显低于常规组;HBO治疗组疗效优于常规治疗组（P〈0.05）;脑梗死患者神经功能缺损评分减少值与患者发病后第3天血清MMP-9水平呈负相关（r=-0.625,P〈0.01）。结论 HBO治疗能降低脑梗死患者升高的血清MMP-9浓度,减少神经功能缺失程度,其临床疗效可能与降低患者血清MMP-9的浓度有关。

Effects of hyperbaric oxygen therapy on serum concentrations of matrix metalloproteinase-9 in patients with cerebral infarction

Objective To observe the dynamic changes of matrix metallo-proteinase-9 （MMP-9） concentration in patients with cerebral infarction treated by hyperbaric oxygen （HBO） and to investigate the relationship between MMP-9 concentration and the therapeutic effect.Methods The concentrations of MMP-9 were measured by enzyme-linked immunosorbent assay（ELISA）. The blood samples were collected on admission,at the 3rd,5th and 10th day after treatment. The nerve function impairment scores were estimated on admission,at 10 days and a month after treatment,and therapeutic effects were evaluated a month after treatment.Results There was no significant difference in MMP-9 concentration on admission between HBO group and routine treatment group. However MMP-9 concentration in the two treatment groups were significantly higher than that of control group（P〈0.01）,which reached a peak at the 3rd day. At the 3rd and 5th day after treatment,MMP-9 concentrations in HBO group were significantly lower than those in routine treatment group （P〈0.05）.The nerve function impairment scores in HBO group were significantly lower than those of routine treatment group after 1-month treatment,and the therapeutic effect in HBO group was superior to that of routine treatment group （P〈0.05）,The reduction scores of nerve function impairment were negatively correlated with the levels of MMP-9 at the 3rd day（P〈0.01）.Conclusion The HBO therapy can reduce the concentration of serum MMP-9 in patients with cerebral infarction,and can decrease the degree of nerve function impairment,its clinical therapeutic effect may be correlated with the decrease of serum concentration of MMP-9.