CAJ | 학술논문

目的探讨成年型烟雾病( moyamoya disease,MMD)患者血管内皮生长因子(vascular endothelial growth factor,VEGF)和基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)血清水平及其与Suzuki分级的关系.方法从南京卒中注册系统中提取2009年4月至2011年1月间以短暂性脑缺血发作或首发卒中的52例住院或门诊复诊的成年型MMD患者.同时选取16名性别和年龄与MMD患者相配匹的健康人作为对照组.通过酶联免疫吸附分析法,比较MMD患者VEGF和MMP-9血清水平与健康对照人群间的差异；根据Suzuki 6级分级标准,将MMD患者分为不同亚组,分别分析不同亚组VEGF和MMP-9血清水平与Suzuki分级的相关性；另外,对MMD患者VEGF和MMP-9血清水平的相关性亦作了分析.结果缺血型和出血型MMD患者VEGF血清水平分别为(289.4±69.2)pg/ml和(324.3±95.6) pg/ml,均高于健康对照组[(63.5±7.6) pg/ml；F=69.43;P ＜0.01]；缺血型和出血型MMD患者MMP-9血清水平分别为(499.4±76.2)ng/ml和(531.2±100.2)ng/ml,亦均高于健康对照组[(257.1±30.7)ng/ml；F =66.023;P ＜0.01].随着Suzuki分级的升高,VEGF和MMP-9血清水平呈现升高趋势,相关系数r分别为0.879(P ＜0.01)和0.838(P ＜0.01).另外,VEGF和MMP-9之间存在正向线性相关(r=0.590,P＜0.01).结论成年型MMD患者VEGF和MMP-9血清水平高于健康人群,提示参与了血管新生；随着患者病情的进展,VEGF和MMP-9血清水平呈现升高趋势,提示VEGF和MMP-9血清水平能反映患者的病变严重程度.
목적 탐토성년형연무병( moyamoya disease,MMD)환자혈관내피생장인자(vascular endothelial growth factor,VEGF)화기질금속단백매-9(matrix metalloproteinase-9,MMP-9)혈청수평급기여Suzuki분급적관계.방법 종남경졸중주책계통중제취2009년4월지2011년1월간이단잠성뇌결혈발작혹수발졸중적52례주원혹문진복진적성년형MMD환자.동시선취16명성별화년령여MMD환자상배필적건강인작위대조조.통과매련면역흡부분석법,비교MMD환자VEGF화MMP-9혈청수평여건강대조인군간적차이；근거Suzuki 6급분급표준,장MMD환자분위불동아조,분별분석불동아조VEGF화MMP-9혈청수평여Suzuki분급적상관성；령외,대MMD환자VEGF화MMP-9혈청수평적상관성역작료분석.결과 결혈형화출혈형MMD환자VEGF혈청수평분별위(289.4±69.2)pg/ml화(324.3±95.6) pg/ml,균고우건강대조조[(63.5±7.6) pg/ml；F=69.43;P ＜0.01]；결혈형화출혈형MMD환자MMP-9혈청수평분별위(499.4±76.2)ng/ml화(531.2±100.2)ng/ml,역균고우건강대조조[(257.1±30.7)ng/ml；F =66.023;P ＜0.01].수착Suzuki분급적승고,VEGF화MMP-9혈청수평정현승고추세,상관계수r분별위0.879(P ＜0.01)화0.838(P ＜0.01).령외,VEGF화MMP-9지간존재정향선성상관(r=0.590,P＜0.01).결론 성년형MMD환자VEGF화MMP-9혈청수평고우건강인군,제시삼여료혈관신생；수착환자병정적진전,VEGF화MMP-9혈청수평정현승고추세,제시VEGF화MMP-9혈청수평능반영환자적병변엄중정도.
Objective To investigate the relationship between serum levels of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) and Suzuki' s grading system in adult moyamoya disease (MMD).Methods Fifty-two adult patients with MMD,who were diagnosed in Jinling hospital between April 2009 and January 2010,were retrieved from the Nanjing Stroke Registry Program (NSRP).Sixteen sex- and age-matched healthy individuals with MMD patients consisted of the control group.Using enzyme-linked immunosorbent assay,serum concentrations of VEGF and MMP-9 were compared between adult MMD patients and healthy individuals.By Suzuki' s six-grading system,patients were divided into different subgroups,and the correlation of serum levels of VEGF and MMP-9 corresponding to different subgroup and Suzuki's grading was respectively analyzed.In addition,the correlation of serum levels of VEGF and MMP-9 was also evaluated.Results Serum VEGF concentrations in ischemic and hemorrhagic MMD patients was respectively ( 289.4 + 69.2 ) pg/ml and ( 324.3 ± 95.6 ) pg/ml and were significantly higher compared to those in healthy controls ( ( 63.5 ± 7.6 ) pg/ml; F =69.43,P ＜ 0.01 ).Similar findings were observed for MMP-9 ( ( 499.4 ± 76.2 ) ng/ml and ( 531.2 + 100.2 ) ng/ml versus (257.1 ±30.7) ng/ml; F =66.023,P ＜0.01 ).With the increase of Suzuki' s grading,serum levels of VEGF and MMP-9 respectively showed a high trend ( r =0.879,P ＜ 0.01:r =0.838,P ＜ 0.01 ).In addition,a positive correlation between serum levels of VEGF and MMP-9 was found in the MMD group( r =0.590,P ＜0.01 ).Conclusion The results show that serum levels of VEGF and MMP-9 in adult MMD are higher than those in healthy controls,which may play a role in neovascularization in MMD,and moreover,serum levels of VEGF and MMP-9 show a high trend with the progression of MMD,which suggest that serum levels of VEGF and MMP-9 can reflect the severity of MMD.