颅内出血足月新生儿血清基质金属蛋白酶-9及其抑制剂水平的动态变化

目的探讨颅内出血足月新生儿血清基质金属蛋白酶(MMP)-9、基质金属蛋白酶组织因子(TIMP)-1水平动态变化及其临床意义。方法采用酶联免疫吸附试验法(ELISA)分别测定30例颅内出血患儿在生后1 d内,3、7、15天血清MMP-9、TIMP-1水平及其两者比值,并与30例健康足月新生儿进行对照比较。结果颅内出血足月新生儿血清MMP-9、TIMP-1及MMP-9/TIMP-1水平明显高于对照组(P<0.01),以出生后3 d内MMP-9、TIMP-1水平及MMP-9/TIMP-1最高,7 d后开始下降,随病情恢复其水平缓慢下降,15 d部分患儿恢复正常,但与对照组比较差异仍有统计学意义(P<0.05)。小、中、大量出血患儿血清MMP-9、TIMP-1及MMP-9/TIMP-1与对照组比较,差异均有统计学意义(P<0.01);三组间比较,差异均有统计学意义(P<0.01)。结论颅内出血足月新生儿血清MMP-9、TIMP-1及MMP-9/TIMP-1水平均明显增高,可作为判定病情和评估预后的参考指标。

Changes of serum levels of matrix metalloproteinase-9 and its inhibitor in newborns with intracranial hemorrhage

Objective To study the changes and clinical significance of serum levels of matrix metalloproteinase-9 and its inhibitor in newborns with intracranial hemorrhage.Methods Thirty neonates with intracranial haemorrhage were enrolled in the study and 30 healthy neonates were studied as control.Blood samples were collected at 1 d,3 d,7 d,15 d after onset,and serum levels of matrix metalloproteinase(MMP)-9 and tissue inhibitor of metalloproteinases(TIMP)-1 were measured by enzyme linked immunosorbent assay(ELISA).Results Levels of MMP-9,TIMP-1 and MMP-9/TIMP-1 were significantly higher in the patient group than those in control(P < 0.01).Levels of MMP-9,TIMP-1 and MMP-9/TIMP-1 were highest on 3 d,but began to descend on 7 d.With the recovery of pathogenetic condition,the levels of MMP-9,TIMP-1 and MMP-9/TIMP-1 descended slowly,and recovered normal on 15 d in part of the children,Nevertheless,compared to the controls,these three indexes still remained statistically significant(P < 0.05).In comparison with the controls,levels of MMP-9,TIMP-1 and MMP-9/TIMP-1 in small,medium and large intracranial hemorrhage patients were significantly higher(P < 0.01).The difference of three indexes between these three groups were also significant(P < 0.01).Conclusions Serum levels of MMP-9,TIMP-1 and MMP-9/ TIMP-1 increases obviously in newborns with intracranial hemorrhage,suggesting that they might be used as reference index in assessing pathogenetic condition and appraising prognosis.