血清基质金属蛋白酶-2在急性脑梗死治疗低分子肝素实验各分型中的动态变化及其意义

目的观察血清基质金属蛋白酶-2（MMP-2）在急性脑梗死（ACI）患者急性卒中治疗低分子肝素试验（TOAST）各病因分型中含量的动态变化及意义。方法将80例ACI患者按照TOAST标准进行病因分型，用酶联免疫吸附（ELISA）法检测各分型ACI患者在发病第24小时、7天的血清MMP-2含量，及与之相匹配的43例正常对照者的血清MMP-2含量。从而比较MMP-2在ACI患者TOAST各病因分型中的含量动态变化。结果TOAST病因分型构成：心源性脑栓塞（CE）14例（17．50％）；大动脉粥样硬化性卒中（LAA）29例（36．25％）；小动脉卒中（腔隙性脑梗死，SAA）24例（30．00％）；其他原因引发的缺血性卒中（SOE）6例（7．50％）；原因不明的缺血性卒中（SUE）7例（8．75％）。ACI组患者发病24h、7d血清MMP-2水平均高于对照组（P〈0．05）；TOAST各分型中，SOE、SUE因例数少未作分析。其它各型中，LAA、SAA、CE组血清MMP-2水平高于对照组（P〈0．05），其中以LAA组增高最显著（P〈0．01）；且其MMP-2表达具有动态变化。结论ACI患者MMP-2水平随TOAST亚型的不同而变化，在LAA中浓度升高最显著，说明脑梗死不同亚型可能具有不同病因。

The serial measurement and significance of matrix metalloproteinase-2 in serum of acute cerebral infarction patients according to TOAST criteria

Objective To investigate the dynamic change and significance of matrix metalloproteinase -2 （ MMP -2） in serum of acute cerebral infarction（ACI） patients according to TOAST criteria. Methods Eighty patients with acute cerebral infarction and 43 healthy individuals were enrolled in this trial. All the patients were classified into five subtypes according to TOAST criteria. Serum MMP -2 level was measured at hour 24 and on day 7 after the onset of ACI, and healthy subjects by ELISA. And then the relationship between MMP - 2 levnd their TOAST subtypes were analyzed. Results According to the TOAST classification, 14 patients（ 17.50% ） had cardiogenic cerebral embolism（CE） ,29 patients （36.25%） had large -artery atherosclerosis（LAA） ,24 patients＇（30.00% ） had small -artery occlusion lacunar（SAA） ,6 patients（7.50% ） had stroke of other determined etiology（SOE） and 7 patients（ 8.75% ） were classified as stroke of undetermined etiology subtype（SUE）. Dynamic change of serum MMP - 2 level was observed in the study. In addition, serum MMP - 2 of ACI patients was significantly higher than that of controls at 24 h and on day 7 after the onset of ACI（ P 〈 0.05 ）. Concerning the subtypes, the level of serum MMP - 2 was higher in patients with LAA, SAA and CE than that in controls and the level of serum MMP- 2 in patients with LAA was the highest in ACI（ P 〈 0.0l ）. Conclusion The level of serum MMP - 2 varied with different subtypes of ACI, especially increases in subtype LAA indicating different subtypes of ACI may have different pathogenesis.