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既往他汀类药物治疗对接受溶栓治疗的中国卒中患者血浆基质金属蛋白酶-9水平的影响。

The effects of previous statin treatment on plasma matrix metalloproteinase-9 level in Chinese stroke patients undergoing thrombolysis.

作者信息

Zhao Hong-Dong, Zhang Ying-Dong

机构信息

Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, PR China.

Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, PR China.

出版信息

J Stroke Cerebrovasc Dis. 2014 Nov-Dec;23(10):2788-2793. doi: 10.1016/j.jstrokecerebrovasdis.2014.07.001. Epub 2014 Oct 12.

Abstract

It is unclear whether previous statin therapy influences the prognosis, hemorrhagic transformation, and plasma matrix metalloproteinases (MMP)-9 levels in Chinese stroke patients receiving intravenous thrombolysis. We conduct a prospective cohort study of 193 patients treated with intravenous thrombolysis. All the enrolled patients were divided into 2 groups (the control group and the statin group), according to the previous history of statin use. The plasma MMP-9 levels were detected before and at 6 hours, 12 hours, 24 hours, and 72 hours after intravenous thrombolysis. The clinical outcome of stroke was measured in terms of the functional outcome and occurrence of symptomatic intracerebral hemorrhage. The MMP-9 levels increased after thrombolysis in statin group and control group. No significant intergroup difference was found in the MMP-9 levels before and at 6 hours after thrombolysis, but the levels were significantly lower in the statin group than in the control group at 12, 24, and 72 hours (P < .001) after thrombolysis. Similarly, no significant intergroup difference was noted in the occurrence of symptomatic intracranial hemorrhage as was the case with the modified Rankin scale (assessed by the Mann-Whitney U test) at 7 days (P = .428) and 90 days (P = .419) after thrombolysis. Our results indicate that pretreatment with statin can inhibit the thrombolysis-induced increase in plasma MMP-9 levels but does not significantly affect the prognosis of acute ischemic stroke patients undergoing intravenous thrombolysis.

摘要

对于接受静脉溶栓治疗的中国卒中患者,既往他汀类药物治疗是否会影响其预后、出血性转化及血浆基质金属蛋白酶(MMP)-9水平尚不清楚。我们对193例接受静脉溶栓治疗的患者进行了一项前瞻性队列研究。根据既往他汀类药物使用史,将所有纳入的患者分为2组(对照组和他汀组)。在静脉溶栓前以及溶栓后6小时、12小时、24小时和72小时检测血浆MMP-9水平。根据功能转归和症状性脑出血的发生情况来衡量卒中的临床结局。他汀组和对照组溶栓后MMP-9水平均升高。溶栓前及溶栓后6小时,两组MMP-9水平无显著组间差异,但溶栓后12小时、24小时和72小时,他汀组的MMP-9水平显著低于对照组(P <.001)。同样,溶栓后7天(P =.428)和90天(P =.419),症状性颅内出血的发生率及改良Rankin量表评分(通过Mann-Whitney U检验评估)在两组间均无显著差异。我们的结果表明,他汀类药物预处理可抑制溶栓诱导的血浆MMP-9水平升高,但对接受静脉溶栓治疗的急性缺血性卒中患者的预后无显著影响。

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