急性缺血性脑卒中血脑屏障功能障碍的生化标志物与演变和结局相关。
Biochemical markers for blood-brain barrier dysfunction in acute ischemic stroke correlate with evolution and outcome.
机构信息
Department of Neurology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
出版信息
Eur Neurol. 2011;65(1):23-31. doi: 10.1159/000321965. Epub 2010 Dec 7.
BACKGROUND/AIMS: We evaluated the cerebrospinal fluid/serum albumin ratio (AR) and kinetics of matrix metalloproteinase-9 (MMP-9) in blood as markers for blood-brain barrier (BBB) disruption after acute ischemic stroke.
METHODS
The AR was determined in 88 patients with acute ischemic stroke or transient ischemic attack. MMP-9 was measured on admission, 24, 72 h and 7 days after stroke onset.
RESULTS
The AR was related to stroke severity, the occurrence of stroke progression and the modified Rankin Scale score at month 3. MMP-9 levels on admission were significantly elevated compared to controls and dropped in the first 72 h after stroke, except in patients with stroke progression and larger infarcts in the subacute phase.
CONCLUSIONS
We demonstrate that the extent of BBB breakdown in hyperacute stroke relates to initial stroke severity, stroke evolution and long-term outcome. The kinetics of MMP-9 confirm its pivotal role in secondary brain damage after ischemic stroke.
背景/目的：我们评估了急性缺血性卒中后血脑屏障（BBB）破坏的脑脊液/血清白蛋白比值（AR）和基质金属蛋白酶-9（MMP-9）动力学。
方法
在 88 例急性缺血性卒中和短暂性脑缺血发作患者中测定 AR。MMP-9 在发病后 24、72 小时和 7 天进行测量。
结果
AR 与卒中严重程度、卒中进展的发生和 3 个月时改良 Rankin 量表评分相关。与对照组相比，入院时 MMP-9 水平显著升高，并在卒中后前 72 小时内下降，除了在亚急性期出现卒中进展和较大梗死的患者中。
结论
我们证明了超急性期卒中 BBB 破坏的程度与初始卒中严重程度、卒中演变和长期预后相关。MMP-9 的动力学证实了其在缺血性卒中后继发性脑损伤中的关键作用。
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