早期他汀治疗对急性脑梗死静脉溶栓患者血浆基质金属蛋白酶-9水平及短期预后的影响

发布时间：2018-10-31 07:53

【摘要】：目的探讨早期他汀治疗对急性脑梗死静脉溶栓患者血浆基质金属蛋白酶(MMP)-9水平及短期预后的影响。方法将193例急性脑梗死静脉溶栓患者分为早期他汀治疗组(72例)和溶栓后他汀治疗组(121例)。采用ELISA法检测患者溶栓前及溶栓后6 h、12 h、24 h、72 h的血浆MMP-9水平。第7 d和第90 d时采用mRS评分评价患者的预后,并比较两组症状性颅内出血发生率。结果溶栓后他汀治疗组及早期治疗组性别、年龄、溶栓时间窗、血压、既往史、实验室检查、NIHSS评分、TOAST分型及OCSP卒中分型差异均无统计学意义(均P0.05)。两组间溶栓前血浆MMP-9水平差异无统计学意义(P0.05)。与溶栓后他汀治疗组比较,早期他汀治疗组溶栓后6 h、12 h、24 h及72 h的MMP-9水平均显著降低(t=2.64,t=-9.85,t=-8.88,t=-5.62;均P0.01)。早期他汀治疗组溶栓后症状性颅内出血发生率及神经功能缺损评分差异无统计学意义(均P0.05)。早期他汀治疗组第7 d及第90 d mRS评分预后良好的比率显著高于溶栓后他汀治疗组(均P0.05)。结论早期他汀类药物治疗对急性脑梗死溶栓患者的MMP-9水平有抑制作用,不增加溶栓后症状性颅内出血的风险,可改善急性脑梗死的短期预后。
[Abstract]:Objective to investigate the effect of early statin therapy on plasma matrix metalloproteinase-9 (MMPs) (MMP)-9 levels and short-term prognosis in patients with acute cerebral infarction after intravenous thrombolytic therapy. Methods 193 patients with acute cerebral infarction were divided into early statin group (72 cases) and post thrombolytic statin group (121 cases). The plasma MMP-9 levels before and after thrombolysis were measured by ELISA method at 24 h and 72 h before and 6 h after thrombolysis. The prognosis of the patients was evaluated by mRS score on the 7th and 90th day, and the incidence of symptomatic intracranial hemorrhage was compared between the two groups. Results there was no significant difference in sex, age, thrombolytic time window, blood pressure, past history, laboratory examination, NIHSS score, TOAST classification and OCSP stroke type between the treatment group and the early treatment group (P0.05). There was no significant difference in plasma MMP-9 levels between the two groups before thrombolysis (P0.05). Compared with the post-thrombolytic statin treatment group, the MMP-9 levels in the early statin treatment group were significantly lower than those in the early statin group at 12 h after thrombolysis at 24 h and 72 h after thrombolytic therapy. There was no significant difference in the incidence of symptomatic intracranial hemorrhage after thrombolytic therapy and neurological deficit score in early statins group (P0.05). The rate of good prognosis in the early statin group was significantly higher than that in the post-thrombolytic statin group (P0.05). Conclusion early statin therapy can inhibit the level of MMP-9 in patients with acute cerebral infarction without increasing the risk of symptomatic intracranial hemorrhage after thrombolytic therapy and can improve the short-term prognosis of acute cerebral infarction.
【作者单位】：南京医科大学附属南京医院(南京市第一医院)神经内科;
【分类号】：R743.3

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