MMP-2、MMP-9在自发性蛛网膜下腔出血患者血清中的表达与脑血管痉挛的相关性研究
发布时间：2018-08-03 13:14
【摘要】：目的： 本研究是分析基质金属蛋白酶-2（MMP-2）和基质金属蛋白酶-9在脑动脉瘤破裂患者术后4-14天外周血清浓度的变化与脑血管痉挛的关系，从而探讨它们作为脑动脉瘤破裂蛛网膜下腔出血患者术后脑血管痉挛严重程度指标的可能。 方法： 采用明胶酶谱法对35例经手术治疗破裂的脑动脉瘤（开颅夹闭术和介入栓塞术）患者自发病后第四天起隔天连续采取外周血样本进行分析，并对门诊健康志愿者在同一时间采血分析，用医学图像系统进行定量计算，同时对手术患者行经颅多普勒超声检测，判断脑血管痉挛程度并与MMP-2、MMP-9表达水平进行比较。 结果： 脑动脉瘤破裂引起自发性蛛网膜下腔出血患者血清中MMP-2和MMP-9值高于正常人且MMP-9升高水平更为明显，并且与正常组对比，，MMP-2与MMP-9均有统计意义（P＜0.05），而且MMP-9有显著差异（P＜0.01），其中，MMP-9表达水平的变化程度与脑血管痉挛严重程度有临床相关（P＜0.01），MMP-2的变化程度与脑血管痉挛严重程度无临床相关（P＞0.05）；多发脑动脉瘤破裂患者血清中MMP-2、MMP-9表达水平与单发脑动脉瘤患者血清中MMP-2、MMP-9表达水平比较无临床相关（P＞0.05）；不同性别患者血清中MMP-2、MMP-9表达水平比较无临床相关（P＞0.05）；不同年龄患者血清中MMP-2、MMP-9表达水平比较无临床相关（P＞0.05）；行脑动脉瘤开颅夹闭术患者血清中MMP-9表达水平与行脑动脉瘤介入治疗患者血清中MMP-2、MMP-9表达水平比较无临床相关(P＞0.05)；血清MMP-9表达水平在第4天起上升，并在第6-8天达到高峰，此后逐渐下降，第14天左右表达水平较正常值稍高，MMP-2在第4天即出现高表达，随后稍微下降，第8-10天左右再次达到高峰，并逐渐下降，但第14天左右表达水平仍较正常值高。 结论： 血清MMP-2、MMP-9表达水平在脑动脉瘤破裂患者中明显升高，且MMP-9表达水平变化与动脉瘤患者脑血管痉挛程度呈正相关；MMP-2虽也呈高表达，但与脑血管痉挛程度无明显相关性。MMP-9的表达水平有望成为脑动脉瘤破裂引起自发性蛛网膜下腔出血患者脑血管痉挛的诊断指标，并为后续治疗方案提供指导。
[Abstract]:Objective: to study the relationship between the changes of serum concentration of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) and cerebral vasospasm in patients with ruptured cerebral aneurysms 4-14 days after operation. To explore the possibility of cerebral vasospasm severity in patients with ruptured cerebral aneurysm subarachnoid hemorrhage. Methods: 35 patients with ruptured cerebral aneurysms (craniotomy and interventional embolization) were analyzed by gelatinase spectrum. Blood samples were collected from healthy volunteers at the same time and the quantitative calculation was made by medical image system. At the same time, the degree of cerebral vasospasm was judged by transcranial Doppler ultrasound and the expression level of MMP-9 was compared with that of MMP-2. Results: the serum levels of MMP-2 and MMP-9 in patients with spontaneous subarachnoid hemorrhage caused by rupture of cerebral aneurysm were higher than those in normal controls and the level of MMP-9 was higher than that in normal controls. Compared with normal group, MMP-2 and MMP-9 had statistical significance (P < 0. 05), and MMP-9 had significant difference (P < 0. 01). The change of MMP-9 expression was related to the severity of cerebral vasospasm (P < 0. 01). The severity of spasm had no clinical correlation (P > 0.05). There was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with multiple ruptured cerebral aneurysms (P > 0.05), there was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with multiple aneurysms (P > 0.05), and there was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with multiple aneurysms (P > 0.05). There was no clinical correlation between the expression of MMP-2 and MMP-9 in serum of patients with different ages (P > 0. 05), and there was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with intracranial aneurysm closure and interventional therapy (P > 0. 05). The expression of MMP-9 in serum increased on the 4th day, reached its peak at 6-8 days, then decreased gradually. On the 14th day, the expression of MMP-2 was a little higher than the normal value, and the expression of MMP-2 increased on the 4th day, and then decreased slightly. On the 8th to 10th day, the expression reached the peak again, and gradually decreased, but the expression level was still higher than the normal value on the 14th day. Conclusion: the expression of MMP-2 and MMP-9 in patients with ruptured cerebral aneurysms was significantly increased, and the expression of MMP-9 was positively correlated with the degree of cerebral vasospasm in patients with cerebral aneurysms. However, the expression of MMP-9 in patients with spontaneous subarachnoid hemorrhage caused by rupture of cerebral aneurysm is expected to be the diagnostic index of cerebral vasospasm, and it may provide guidance for the treatment of cerebral vasospasm in patients with spontaneous subarachnoid hemorrhage caused by rupture of cerebral aneurysms.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.35
本文编号：2161855
[Abstract]:Objective: to study the relationship between the changes of serum concentration of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) and cerebral vasospasm in patients with ruptured cerebral aneurysms 4-14 days after operation. To explore the possibility of cerebral vasospasm severity in patients with ruptured cerebral aneurysm subarachnoid hemorrhage. Methods: 35 patients with ruptured cerebral aneurysms (craniotomy and interventional embolization) were analyzed by gelatinase spectrum. Blood samples were collected from healthy volunteers at the same time and the quantitative calculation was made by medical image system. At the same time, the degree of cerebral vasospasm was judged by transcranial Doppler ultrasound and the expression level of MMP-9 was compared with that of MMP-2. Results: the serum levels of MMP-2 and MMP-9 in patients with spontaneous subarachnoid hemorrhage caused by rupture of cerebral aneurysm were higher than those in normal controls and the level of MMP-9 was higher than that in normal controls. Compared with normal group, MMP-2 and MMP-9 had statistical significance (P < 0. 05), and MMP-9 had significant difference (P < 0. 01). The change of MMP-9 expression was related to the severity of cerebral vasospasm (P < 0. 01). The severity of spasm had no clinical correlation (P > 0.05). There was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with multiple ruptured cerebral aneurysms (P > 0.05), there was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with multiple aneurysms (P > 0.05), and there was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with multiple aneurysms (P > 0.05). There was no clinical correlation between the expression of MMP-2 and MMP-9 in serum of patients with different ages (P > 0. 05), and there was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with intracranial aneurysm closure and interventional therapy (P > 0. 05). The expression of MMP-9 in serum increased on the 4th day, reached its peak at 6-8 days, then decreased gradually. On the 14th day, the expression of MMP-2 was a little higher than the normal value, and the expression of MMP-2 increased on the 4th day, and then decreased slightly. On the 8th to 10th day, the expression reached the peak again, and gradually decreased, but the expression level was still higher than the normal value on the 14th day. Conclusion: the expression of MMP-2 and MMP-9 in patients with ruptured cerebral aneurysms was significantly increased, and the expression of MMP-9 was positively correlated with the degree of cerebral vasospasm in patients with cerebral aneurysms. However, the expression of MMP-9 in patients with spontaneous subarachnoid hemorrhage caused by rupture of cerebral aneurysm is expected to be the diagnostic index of cerebral vasospasm, and it may provide guidance for the treatment of cerebral vasospasm in patients with spontaneous subarachnoid hemorrhage caused by rupture of cerebral aneurysms.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.35
【参考文献】
相关期刊论文 前1条
1 张宇,诸葛启钏,瞿宣兴,赵继宗,郑伟明,钟鸣,吴近森;脑动脉瘤病理改变与基质金属蛋白酶(MMPs)的表达[J];温州医学院学报;2003年02期
本文编号：2161855
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