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目的探讨急性脑出血患者血浆基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶组织抑制剂-1(TIMP-1)动态变化及与脑出血水肿的相关性。方法随机选取2014年7月-2015年7月于航天中心医院神经内科行急性脑出血治疗的患者50例为实验组。同时选取20名本院健康体检者为对照组。分别测定这两组各个时间点血浆中的MMP-9及TIMP-1的浓度,在24 h内和住院14 d后进行头部CT检测,观察MMP-9及TIMP-1的浓度与脑水肿的关系。结果两组患者在性别、年龄等基线资料差异无统计学意义(P>0.05),脑出血病人在发病24 h内血浆中MMP-9、TIMP-1含量增大,随着病程的增加,血浆中MMP-9、TIMP-1含量进一步增加,在第5天左右达到高峰,然后血浆MMP-9、TIMP-1含量逐渐下降。急性脑出血患者血浆中MMP-9、TIMP-1的异常表达在开始阶段,高峰期同步呈正相关(r=0.762,P<0.05),在14 d后MMP-9、TIMP-1含量无相关性。在患者入院治疗24 h后对患者进行头部CT检测,水肿体积与MMP-9在血浆中的浓度呈正相关(r=0.936,P<0.05),与TIMP-1在血浆中的浓度呈负相关(r=-0.622,P<0.05),14 d后再次复查水肿体积依然与MMP-9在血浆中的浓度呈正相关(r=0.859,P<0.05)。结论急性脑出血患者血浆内MMP-9及TIMP-1浓度在发病24 h内迅速增高,5 d达到峰值,然后开始下降。急性脑出血患者脑水肿体积与血浆内MMP-9浓度正相关,与TIMP-1浓度负相关。
Objective To investigate the dynamic changes of plasma matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in patients with acute cerebral hemorrhage and their correlation with cerebral hemorrhage and edema. Methods Fifty patients randomly selected from Department of Neurology, Department of Neurology, Cosmonautics Center from July 2014 to July 2015 were selected as the experimental group. At the same time, 20 healthy people in our hospital were selected as the control group. The concentrations of MMP-9 and TIMP-1 in plasma at each time point were measured respectively. CT scans were performed within 24 hours and 14 days after hospitalization. The concentrations of MMP-9 and TIMP-1 and the changes of brain edema relationship. Results There was no significant difference in the baseline data between the two groups (P> 0.05). The content of MMP-9 and TIMP-1 in the patients with ICH increased within 24 hours after onset. With the increase of the course of the disease, MMP-9, TIMP-1 levels further increased, reached a peak on the 5th day, and then decreased the level of plasma MMP-9, TIMP-1. The abnormal expression of MMP-9 and TIMP-1 in the plasma of patients with acute cerebral hemorrhage was positively correlated with the peak at the initial stage (r = 0.762, P <0.05), and there was no correlation between the levels of MMP-9 and TIMP-1 after 14 d . Twenty-four hours after admission, CT scans of patients were performed. The edema volume was positively correlated with the concentration of MMP-9 in plasma (r = 0.936, P <0.05), and negatively correlated with the concentration of TIMP-1 in plasma (r = -0.622, P <0.05). After 14 days, the edema volume was still positively correlated with the concentration of MMP-9 in plasma (r = 0.859, P <0.05). Conclusion The concentration of MMP-9 and TIMP-1 in plasma of patients with acute intracerebral hemorrhage increased rapidly within 24 h after onset and peaked on the 5th day, then began to decrease. The volume of brain edema in patients with acute cerebral hemorrhage was positively correlated with the concentration of plasma MMP-9, and negatively correlated with the concentration of TIMP-1.