血清MMP-9和TIMP-1与脑梗死后认知障碍的关系

发布时间：2018-06-27 02:21

本文选题：血管性痴呆 + 基质金属蛋白酶-　；参考：《中风与神经疾病杂志》2014年05期

【摘要】：目的研究血清基质金属蛋白酶-9(Matrix Metalloproteinase-9,MMP-9)和组织金属蛋白酶抑制剂-1(Tissue Inhibitor of Metalloproteinase-1,TIMP-1)水平与脑梗死后认知功能障碍的关系。方法陈旧脑梗死患者根据简易智力状态量表(Mini-Mental State Examination,MMSE)评分分为认知障碍组(小于等于26分)、对照组(大于26分)和健康受试者。通过ELISA法测定血清MMP-9和TIMP-1水平。结果认知障碍组42例,MMSE评分21.50±4.88。对照组81例,MMSE评分28.75±0.96。与健康受试者相比,认知障碍组和对照组患者血清MMP-9及TIMP-1水平均显著升高(P0.01,P0.01);与对照组比较,认知障碍组患者血清TIMP-1显著升高(P=0.049),而MMP-9水平无显著差异。Logistic回归显示年龄(OR=1.096,P0.001,95%CI1.043~1.152)、MMP-9(OR=0.33,P=0.035,95%CI 0.118~0.926)和TIMP-1(OR=4.99,P=0.004,95%CI1.688~14.741)是认知功能障碍的独立危险因素。相关分析显示,MMP-9和TIMP-1水平均与美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)(r=0.27,P=0.003;r=0.24,P=0.008)和改良Rankin评分(modified Rankin Scale,mRS)(r=0.25,P=0.01;r=0.23,P=0.02)呈正相关。结论陈旧脑梗死患者中存在认知障碍者血清MMP-9水平降低且TIMP-1水平升高,有望成为预测梗死后认知障碍的生化标志物。
[Abstract]:Objective to study the relationship between the levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) and cognitive impairment after cerebral infarction. Methods patients with old cerebral infarction were divided into cognitive impairment group (< 26 points), control group (> 26 points) and healthy subjects according to Mini-Mental State examination scale (MMSE). The serum levels of MMP-9 and TIMP-1 were measured by Elisa. Results the MMSE score of 42 patients with cognitive impairment was 21.50 卤4.88. The MMSE score of 81 cases in the control group was 28.75 卤0.96. The levels of MMP-9 and TIMP-1 in the patients with cognitive impairment and control group were significantly higher than those in the healthy subjects (P 0.01), and those in the control group were significantly higher than those in the control group. There was no significant difference in the level of MMP-9 in the patients with cognitive impairment. Logistic regression analysis showed that age (ORT 1.096), P 0.001 P 0.001, CI 1.043 (1.152) and TIMP-1 (OR4.99P0.004 95 CI 0.1180.926) and TIMP-1 (OR4.99P0.004) were independent risk factors of cognitive dysfunction. The correlation analysis showed that the levels of MMP-9 and TIMP-1 were positively correlated with the National Institute of Health Stroke scale NIHSS (rr 0.27) and the modified Rankin scale (0.23 P0. 02). Conclusion the level of MMP-9 in patients with cognitive impairment and the level of TIMP-1 in the patients with old cerebral infarction are decreased and the level of TIMP-1 is increased, which is expected to be a biochemical marker for predicting cognitive impairment after infarction.
【作者单位】：北京大学第一医院神经内科;
【分类号】：R749.13;R743.3

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