Wu Cheng-Han, Huang Fu-Yun, Wang Kai-Yu, Huang Sheng-Yue, Yang Rui-Ling, Li Hui-Zhong, Lei Hui-Xin, Lin Ju-Shan, Wang Jin-Min, Yan Xiao-Hua
Department of Neurology, Second Affiliated Hospital of Fujian College of Traditional Chinese Medicine, Fuzhou 350003, China.
Zhonghua Yi Xue Za Zhi. 2008 Jan 15;88(3):174-6.
To investigate the matrix metalloproteinase (MMP)-9 played in secondary brain injury following intracerebral hemorrhage (ICH).
Hematoma fluid and peripheral blood samples were collected from 60 ICH patients, 34 males and 26 females, aged 60 +/- 13 (37 - 81) n the days 1, 4, and 7 after evacuation of hematoma. Peripheral blood samples were collected form. 30 sex, and age-matched healthy adults as normal controls. Cerebrospinal fluid (SCF) samples were collected from 10 sex, and age-matched patients to undergo operation during lumbar anesthesia. ELISA was used to detect the content of MMP-9. Tada formula was used to calculate the perihematomal edema volume. The National Institutes of Health Stroke Scale (NIHHS) and Glasgow Coma Score (GCS) were used to assess the condition of patients.
(1) The MMP-9 levels in the plasma and hematoma fluid of the ICH patients at all time points were all significantly higher than those of the normal controls (all P < 0.01). MMP-9 was not found in the normal CSF. (2) The plasma and hematoma fluid MMP-9 levels were increased already in the day 1, peaked in the day 4, and then kept at a high level until the day 7. (3) The MMP-9 levels in hematoma fluid t all time points were all significantly higher than those in the plasma (all P < 0.01). (4) The MMP-9 level was positively correlated with the hematoma volume and NIHSS score, and negatively correlated with the GCS score (both P < 0.01).
MMP-9 may takes part in the secondary injury after ICH, and its change is correlated with the hydrocephalus of patients. The dynamical change of the plasma MMP-9 level is consistent with the hematoma fluid MMP-9 level after ICH. There is a positive correlation among the MMP-9 level, perihematomal edema volume, and severity of ICH.
探讨基质金属蛋白酶(MMP)-9在脑出血(ICH)后继发性脑损伤中的作用。
收集60例ICH患者(男34例,女26例,年龄60±13岁,范围37-81岁)在血肿清除术后第1、4和7天的血肿液和外周血样本。收集30例性别和年龄匹配的健康成年人外周血样本作为正常对照。从10例性别和年龄匹配的患者在腰麻下行手术时收集脑脊液(CSF)样本。采用酶联免疫吸附测定(ELISA)法检测MMP-9含量。采用多田公式计算血肿周围水肿体积。采用美国国立卫生研究院卒中量表(NIHHS)和格拉斯哥昏迷评分(GCS)评估患者病情。
(1)ICH患者各时间点血浆和血肿液中MMP-9水平均显著高于正常对照组(均P<0.01)。正常脑脊液中未检测到MMP-9。(2)血浆和血肿液中MMP-9水平在第1天即升高,第4天达到峰值,然后持续维持在高水平直至第7天。(3)各时间点血肿液中MMP-9水平均显著高于血浆中MMP-9水平(均P<0.01)。(4)MMP-9水平与血肿体积和NIHSS评分呈正相关,与GCS评分呈负相关(均P<0.01)。
MMP-9可能参与ICH后的继发性损伤,其变化与患者脑积水相关。ICH后血浆MMP-9水平的动态变化与血肿液MMP-9水平一致。MMP-9水平、血肿周围水肿体积和ICH严重程度之间存在正相关。