中国临床康复
中國臨床康複
중국림상강복
CHINESE JOURNAL OF CLINICAL REHABILITATION
2004年
28期
6235-6237
,共3页
脑缺血%脑血管意外%基质金属蛋白酶%预后
腦缺血%腦血管意外%基質金屬蛋白酶%預後
뇌결혈%뇌혈관의외%기질금속단백매%예후
背景:动物实验表明基质金属蛋白酶( matrix metalloproteinases,MMPs)参与了缺血性脑卒中的病理过程并起着重要的作用,在临床上血清基质金属蛋白酶 9( MMP-9)是否可作为反应脑梗死患者梗死体积大小及近期预后的一个重要指标. 目的:探讨 MMP-9水平与脑梗死体积大小,预后关系以及相关影响因素. 设计:以诊断为依据的非随机对照研究. 地点和对象:选自 2002-01/ 2003-04暨南大学第二附属医院神经科住院的、经临床诊断为颈内动脉系统急性脑梗死或腔隙性脑梗死患者 124例,男 88例,女 36例,平均年龄为 (62.34± 14.32)岁.所有病例均符合 1995年第四届脑血管疾病会议修订的各类脑血管疾病诊断要点,根据影像学检查结果将患者分为脑梗死组 74例,腔隙性脑梗死组 50例. 干预:起病后 24 h抽取肘静脉血,用酶联免疫吸附法( ELISA法)测定血清 MMP-9水平,采用免疫比浊法测定 C反应蛋白( C-reactive protein, CRP )水平.根据脑卒中患者临床神经功能缺损程度评分标准 (CNFDS)对患者入院以及发病两周后进行评分. 主要观察指标:血清 MMP-9, CRP水平, 白细胞计数,血脂,脑梗死体积,预后. 结果 : 脑梗死组 MMP-9水平 [(731.55± 226.18) mg/L], CRP 水平 [(8.65± 3.77) mg/L],三酰甘油水平 (1.91± 0.96) mmol/L]及白细胞计数 [(9.17± 1.99)× 109 L-1]明显高于腔隙性脑梗死组 [622.64± 196.72) mg/L,( 6.97± 4.36 ) mg/L,( 1.52± 0.85) mmol/L,( 8.38± 1.84)× 109 L-1],差异有显著性意义( P=0.006, 0.024, 0.023, 0.027); MMP9水平与 CRP水平、白细胞计数呈直线正相关( r=0.224, P=0.013; r=0.289,P=0.001),与预后呈等级正相关( r=0.180,P=0.046). 结论 :脑梗死急性期血清 MMP-9水平可作为反应脑梗死患者梗死体积大小以及近期预后的一个重要指标.
揹景:動物實驗錶明基質金屬蛋白酶( matrix metalloproteinases,MMPs)參與瞭缺血性腦卒中的病理過程併起著重要的作用,在臨床上血清基質金屬蛋白酶 9( MMP-9)是否可作為反應腦梗死患者梗死體積大小及近期預後的一箇重要指標. 目的:探討 MMP-9水平與腦梗死體積大小,預後關繫以及相關影響因素. 設計:以診斷為依據的非隨機對照研究. 地點和對象:選自 2002-01/ 2003-04暨南大學第二附屬醫院神經科住院的、經臨床診斷為頸內動脈繫統急性腦梗死或腔隙性腦梗死患者 124例,男 88例,女 36例,平均年齡為 (62.34± 14.32)歲.所有病例均符閤 1995年第四屆腦血管疾病會議脩訂的各類腦血管疾病診斷要點,根據影像學檢查結果將患者分為腦梗死組 74例,腔隙性腦梗死組 50例. 榦預:起病後 24 h抽取肘靜脈血,用酶聯免疫吸附法( ELISA法)測定血清 MMP-9水平,採用免疫比濁法測定 C反應蛋白( C-reactive protein, CRP )水平.根據腦卒中患者臨床神經功能缺損程度評分標準 (CNFDS)對患者入院以及髮病兩週後進行評分. 主要觀察指標:血清 MMP-9, CRP水平, 白細胞計數,血脂,腦梗死體積,預後. 結果 : 腦梗死組 MMP-9水平 [(731.55± 226.18) mg/L], CRP 水平 [(8.65± 3.77) mg/L],三酰甘油水平 (1.91± 0.96) mmol/L]及白細胞計數 [(9.17± 1.99)× 109 L-1]明顯高于腔隙性腦梗死組 [622.64± 196.72) mg/L,( 6.97± 4.36 ) mg/L,( 1.52± 0.85) mmol/L,( 8.38± 1.84)× 109 L-1],差異有顯著性意義( P=0.006, 0.024, 0.023, 0.027); MMP9水平與 CRP水平、白細胞計數呈直線正相關( r=0.224, P=0.013; r=0.289,P=0.001),與預後呈等級正相關( r=0.180,P=0.046). 結論 :腦梗死急性期血清 MMP-9水平可作為反應腦梗死患者梗死體積大小以及近期預後的一箇重要指標.
배경:동물실험표명기질금속단백매( matrix metalloproteinases,MMPs)삼여료결혈성뇌졸중적병리과정병기착중요적작용,재림상상혈청기질금속단백매 9( MMP-9)시부가작위반응뇌경사환자경사체적대소급근기예후적일개중요지표. 목적:탐토 MMP-9수평여뇌경사체적대소,예후관계이급상관영향인소. 설계:이진단위의거적비수궤대조연구. 지점화대상:선자 2002-01/ 2003-04기남대학제이부속의원신경과주원적、경림상진단위경내동맥계통급성뇌경사혹강극성뇌경사환자 124례,남 88례,녀 36례,평균년령위 (62.34± 14.32)세.소유병례균부합 1995년제사계뇌혈관질병회의수정적각류뇌혈관질병진단요점,근거영상학검사결과장환자분위뇌경사조 74례,강극성뇌경사조 50례. 간예:기병후 24 h추취주정맥혈,용매련면역흡부법( ELISA법)측정혈청 MMP-9수평,채용면역비탁법측정 C반응단백( C-reactive protein, CRP )수평.근거뇌졸중환자림상신경공능결손정도평분표준 (CNFDS)대환자입원이급발병량주후진행평분. 주요관찰지표:혈청 MMP-9, CRP수평, 백세포계수,혈지,뇌경사체적,예후. 결과 : 뇌경사조 MMP-9수평 [(731.55± 226.18) mg/L], CRP 수평 [(8.65± 3.77) mg/L],삼선감유수평 (1.91± 0.96) mmol/L]급백세포계수 [(9.17± 1.99)× 109 L-1]명현고우강극성뇌경사조 [622.64± 196.72) mg/L,( 6.97± 4.36 ) mg/L,( 1.52± 0.85) mmol/L,( 8.38± 1.84)× 109 L-1],차이유현저성의의( P=0.006, 0.024, 0.023, 0.027); MMP9수평여 CRP수평、백세포계수정직선정상관( r=0.224, P=0.013; r=0.289,P=0.001),여예후정등급정상관( r=0.180,P=0.046). 결론 :뇌경사급성기혈청 MMP-9수평가작위반응뇌경사환자경사체적대소이급근기예후적일개중요지표.
BACKGROUND:Matrix metalloproteinases( MMPs) has been proved involving and playing key role in the pathogenesis of ischemic stroke by researches on animals,whether its serum level can be used as an important index for infarct volume of cerebral infarction and short-term prognosis are warmly discussed. OBJECTIVE:To explore the correlations of MMPs with infarct volume and prognosis,as well as its correlative factors. DESIGN:Nonrandomised and case-controlled study based on diagnosis. SETTING and PARTICIPANTS:A total of 124 patients, with diagnosis of acute cerebral infarction of inner-carotid system or lacunal cerebral infarction,were hospitalized in neurological section of the Second Affiliated Hospital of Ji'nan University from January,2002 to April,2003,including 88 males and 36 females with the average age of(62.34± 14.32) years old. All patients accorded with the diagnostic standard by the fourth Cerebravascular Disease Conference in 1995 and divided into cerebral infarction group(CIG,n=74) and lacunal infarction group(LIG,n=50) according to their image results. INTERVENTIONS:Blood samples were collected within 24 hours from the occurrence of stroke for determining the serum level of MMP-9 by enzymelinked immunosorbent assay,meanwhile,C-reactive protein( CRP) was also assessed by immune nephelometry.Scores for clinical nerve functional defect was made at patients entering hospital and two weeks later. MAIN OUTCOME MEASURES:Serum MMP-9,CRP,white blood cell(WBC) counting,blood lipid,infarction volume and prognosis. RESULTS:In cerebral infarction group,the level of MMP-9,CRP,triglyceride and WBC in CIG were[(731.55± 226.18) mg/L],[(8.65± 3.77) mg/L,(1.91± 0.96) mmol/L and(9.17± 1.99)× 109 L-1,respectively],obviously higher than corresponding[(622.64± 196.72) mg/L,( 6.97± 4.36 ) mg/L,( 1.52± 0.85) mmol/L,( 8.38± 1.84)× 109 L-1] of LIG, in lacunal infarction group,difference was statistically significant( P=0.006, 0.024, 0.023, 0.027) ;MMP-9 was found linearly positive correlated with CRP and the number of WBC( r=0.224, P=0.013;r=0.289,P=0.001),and positively correlated with prognosis grades( r=0.180,P=0.046) . CONCLUSION:Serum MMP9 can be used as an important index for infarction volume and shortterm prognosis of stroke in acute phase.
