【摘要】 目的观察基质金属蛋白酶-9(MMP-9)在急性脑梗死溶栓治疗患者血清中的动态变化并探讨其临床意义。方法采取30例急性脑梗死溶栓患者(溶栓前、溶栓后6h、24h、7d、14d)的肘静脉血,检测其不同时期血清MMP-9水平,以同期收住院30例脑供血不足患者的血清MMP-9水平作为基线参考。同时对脑梗死患者溶栓前及溶栓后14d行NIHSS评分,溶栓前及溶栓后90d行日常生活能力评分(mRS)以作为近中期疗效判断指标,并按评分改善程度分组比较其MMP-9水平的差异。结果急性脑梗死患者溶栓前及溶栓后6h、24h、7d、14d血清MMP-9水平均较基线水平有显著提高,且呈动态变化,在溶栓后7d达高峰。溶栓后14d NIHSS评分改善程度与MMP-9峰值水平存在负相关(r=-0.65)。90d mRS评分不同改善程度组其血清MMP-9峰值水平存在差异。结论急性脑梗死溶栓患者血清MMP-9水平呈动态变化,7d达高峰。血清MMP-9峰值水平可以初步预测脑梗死患者溶栓近中期疗效。更多还原

【Abstract】 Objective To investigate the dynamic change of serum matrix metalloproteinase-9 (MMP-9) in pa- tients with acute cerebral infarction at different periods after thrombolysis and explore its clinical significance.Meth- ods Blood samples were collected from 30 patients suffering from acute cerebral infarct before thrombolysis and 6 h, 24h,7d and 14d after the thrombolysis.The serum MMP-9 levels of 30 patients with cerebral blood supply insuffici- ency served as basal line reference.MMP-9 expression was measured by ELISA.At the same time,NIHSS was rated before and 14d after thrombolysis,and modified ranking score (mRS) was rated before and 90d after thrombolysis. Results The expression of serum MMP-9 at different periods after thrombolysis in acute cerebral infarction patients was higher than the base line,and the highest level was on d 7 after thrombolysis.The degree of NIHSS improvement on d14 after thrombolysis was negatively correlated with the peak level of MMP-9.Different 90d mRS change groups had different peak MMP-9 levels.Conclusion The expression of serum MMP-9 after thrombolysis in patients with acute cerebral infarction shows dynamic change and reaches a peak on d 7.The peak level of the MMP-9 can predict preliminarily the efficacy of thrombolysis therapy in patients with acute cerebral infarction.更多还原