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目的探讨基质金属蛋白酶-9(MMP-9)和基质金属蛋白酶抑制因子-1(TIMP-1)的表达水平及其在蛛网膜下腔出血(SAH)中预测脑血管痉挛(CVS)发生的意义。方法采用酶联免疫法检测32例蛛网膜下腔出血(SAH)患者作为实验组,分别于SAH后术前,术后第1、3、7天及出院当天采血,检测血清中MMP-9和TIMP-1的水平,并与20例体检正常者(对照组)进行比较。结果除SAH的CVS患者在第7天TIMP-1蛋白表达趋于正常外,CVS和非CVS患者在术后各时间点观察组血清MMP-9和TIMP-1水平均明显高于对照组,差异有统计学意义(P<0.05),且与患者血浆MMP-9和TIMP-1呈显著正相关(P<0.05);对照组MMP-9和TIMP-1无显著相关性(P>0.05),且SAH的CVS患者较非CVS患者MMP-9在术后第3、7天,增高更明显,SAH术后第3天TIMP-1的表达在CVS和非CVS均明显增高,而在CVS患者在第7天蛋白表达趋于正常。结论 SAH的CVS和非CVS患者血清MMP-9和TIMP-1的蛋白均有显著增高,且CVS患者的TIMP-1蛋白表达时间与非CVS患者有差异,同时检测患者血清MMP-9和TIMP-1的蛋白表达量对预测SAH后CVS的发生具有指导意义。
Objective To investigate the expression of matrix metalloproteinase-9 (MMP-9) and matrix metalloproteinase-1 (TIMP-1) and its significance in predicting the occurrence of cerebral vasospasm (CVS) in subarachnoid hemorrhage (SAH) . Methods 32 cases of subarachnoid hemorrhage (SAH) were detected by enzyme-linked immunosorbent assay (ELISA) as the experimental group. Blood samples were collected before operation, on the 1st, 3rd, 7th day after operation and on the day of discharge respectively. The levels of serum MMP-9 and TIMP-1 levels, and with 20 cases of normal subjects (control group) were compared. Results In CVS patients except SAH, the expression of TIMP-1 protein tended to be normal on day 7, and the levels of serum MMP-9 and TIMP-1 in CVS and non-CVS patients at each time point after operation were significantly higher than those in control group (P <0.05), and there was a significant positive correlation between plasma MMP-9 and TIMP-1 in patients (P <0.05). There was no significant correlation between MMP-9 and TIMP- Compared with non-CVS patients, the levels of MMP-9 in SAH CVS patients were significantly higher than that in non-CVS patients at 3 and 7 days after operation. TIMP-1 expression was significantly increased in CVS and non-CVS on the 3rd day after SAH, On day 7, protein expression tended to be normal. Conclusions The serum levels of MMP-9 and TIMP-1 in patients with CVS and non-CVS were significantly higher than those without CVS, and the expression of TIMP-1 protein in patients with CVS was significantly different from that in patients without CVS. The levels of MMP-9 and TIMP- 1 protein expression in predicting the occurrence of CVS after SAH has instructive significance.