【摘要】 目的研究急性脑梗死患者血清内脏脂肪素(visfatin)与基质金属蛋白酶-9(MMP-9)的动态变化及其相关性,探讨二者在脑梗死发生发展中的作用。方法 157例急性脑梗死患者组(ACI)和70例健康对照组,根据颈动脉彩超将脑梗死组分为无斑块组(NP)43例、稳定斑块组(SP)55例和不稳定斑块组(VP)59例3个亚组。应用双抗体夹心酶联免疫法(ELISA),分别测定对照组和急性脑梗死组发病48 h内、第14天血清visfatin及MMP-9水平,并测定血压、血脂、空腹血糖及体重指数,进行相关分析。结果急性脑梗死患者入院48 h内、第14天血清visfatin及MMP-9水平4组比较差异均有显著性意义(P<0.05)。Visfatin水平与体重指数(r=0.235,P=0.032)和血糖(r=0.351,P=0.026)呈正相关;MMP-9水平与脑梗死体积(r=0.372,P=0.012)、入院NIHSS评分(r=0.243,P=0.010)、血糖(r=0.365,P=0.025)及血压(P<0.05)呈正相关;Visfatin及MMP-9呈正相关(r=0.221,P=0.018)。大梗死灶血清MMP-9明显高于小梗死灶(P<0.05)。结论脑梗死患者血清visfatin与MMP-9水平均升高,二者相互作用,可能在动脉粥样硬化、斑块形成及脑梗死的发生发展中起重要作用。更多还原

【Abstract】 Objectives To investigate dynamic changes of the visfatin and the matrix metallo proteinases-9( MMP-9) and the relationship between them in patients with acute cerebral infarction. To explore the value of visfatin and MMP-9in the development of cerebral infarction. Methods There were 157 patients with acute cerebral infarction( ACl group)and 70 cases of healthy persons. All subjects were detected the characteristic by carotid artery ultra-sonographic. According to the result,ACl group were divided into no plaques group( NP) 、stable plaque group( SP) and vulnerable plaque group( VP). All included subjects were measured serum visfatin and MMP-9 with ELISA within 48 hours of onset and in 14 th day,and to determine the fasting blood glucose( FBG),blood pressure( BP),blood lipids,body mass index( BMI),and so on. and then,to analyze the correlation between the visfatin,MMP-9 and the others. Results The serum levels of visfatin and MMP-9 were significantly higher among the four groups( P < 0. 05) within 48 hours of onset and in 14 th day in patients with acute cerebral infarction. The serum visfatin related positively to the BMI( r = 0. 235,P = 0. 032),the level of FGB( r= 0. 351,P = 0. 026) and the level of MMP-9( r = 0. 221,P = 0. 018). The serum MMP-9 related positively to the infarction area( r = 0. 372,P = 0. 012),the score of NIHSS( r = 0. 243,P = 0. 010),the level of FGB( r = 0. 365,P = 0. 025) and the blood pressure( P < 0. 05). The patients with the big infarction area group had higher serum MMP-9 than the small area group( P < 0. 05). Conclusion The serum levels of visfatin and MMP-9 are markedly increased in patients with acute cerebral infarction. The results suggest that higher serum visfatin and MMP-9 may play a critical role in the development of carotid atherosclerosis,plaque and cerebral infarction.更多还原