Zhao Hong-Dong, Zhang Ying-Dong
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.
J Stroke Cerebrovasc Dis. 2014 Nov-Dec;23(10):2788-2793. doi: 10.1016/j.jstrokecerebrovasdis.2014.07.001. Epub 2014 Oct 12.
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.
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。