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目的探讨MMP-9、TIMP-1水平与脑梗死TOAST分型及预后的关系。方法收集急性脑梗死患者90例,按照TOAST分型分为CE、LAA、SA三组;对照组30例;采用ELISA法,测定发病24 h内、第5 d和第10 d的血清MMP-9、TIMP-1;对照组采清晨空腹血1次,测定血清MMP-9、TIMP-1含量。随访1个月,记录发病1个月时的BI(Barthal Index)来评价预后含量。结果发病后24 h内,TOAST各亚型血清MMP-9含量均升高,与对照组比较差异有统计学意义(P<0.05),其中,CE组和LAA组高于SA组(P<0.05);第14 d各组MMP-9含量均降至正常水平。发病后24 h内,TOAST各亚型血清TIMP-1含量亦均升高,与对照组比较差异有统计学意义(P<0.05),其中,CE组和LAA组高于SA组(P<0.05);第14 d各组TIMP-1含量均降至正常水平。预后较好者其发病24 h内血清MMP-9含量为(567.1±263.0)ng/ml,明显低于预后较差者,其MMP-9含量为(893.7±451.1)ng/ml,两者比较差异有统计学意义(P<0.05)。结论MMP-9作为生物活性指标,有助于急性脑梗死的分型,并为我们提供病变程度和预后的信息,同时也可以作为我们评定预后的指标之一。
Objective To investigate the relationship between the levels of MMP-9, TIMP-1 and TOAST classification and prognosis of cerebral infarction. Methods Ninety patients with acute cerebral infarction were collected and divided into three groups according to TOAST classification: CE, LAA and SA; control group, 30 cases. Serum MMP-9 levels within 24 hours, 5 days and 10 days , And TIMP-1 in the control group. The fasting blood of the control group was taken once a day for determination of the serum levels of MMP-9 and TIMP-1. The patients were followed up for 1 month, and the BI (Barthal Index) at 1 month after onset was recorded to evaluate the prognosis. Results The levels of serum MMP-9 in TOAST subtypes were significantly higher than those in control group within 24 h after onset (P <0.05), and were higher in CE group and LAA group than those in SA group (P <0.05 ); The MMP-9 levels in the 14th day decreased to normal level. Within 24 h after onset, serum levels of TIMP-1 in all subtypes of TOAST also increased, which was significantly higher than that in control group (P <0.05) ). On the 14th day, the levels of TIMP-1 in each group dropped to normal level. The prognosis of the patients with good prognosis within 24 h of serum MMP-9 level was (567.1 ± 263.0) ng / ml, which was significantly lower than those with poor prognosis, the MMP-9 level was (893.7 ± 451.1) ng / ml The difference was statistically significant (P <0.05). Conclusion As a bioactivity index, MMP-9 contributes to the classification of acute cerebral infarction and provides information about the degree and prognosis of the disease. It also can be used as one of the indicators of prognosis.