Zielinska-Turek Justyna, Dorobek Małgorzata, Turek Grzegorz, Barcikowska-Kotowicz Maria
Department of Neurology, Central Clinical Hospital of Ministry of the Interior and Administration, Warsaw, Poland.
Department of Neurology, Central Clinical Hospital of Ministry of the Interior and Administration, Warsaw, Poland.
Neurol Neurochir Pol. 2018 Sep-Oct;52(5):555-561. doi: 10.1016/j.pjnns.2018.05.005. Epub 2018 May 30.
We still lack an optimal tool to predict ischaemic stroke in patients with symptomatic and asymptomatic carotid stenosis (CS). It has already been shown that patients at increased risk of ischaemic stroke can be identified based on the elevated plasma levels of metalloproteinases (MMPs) and reduced activity tissue inhibitor of metalloproteinase (TIMP). There are few studies presenting the role of MMP-9 and TIMP in ischaemic stroke both in patients with symptomatic and asymptomatic CS treated with stenting or endarterectomy, however we have not found any published review summarizing the role of abovementioned markers. MEDLINE was accessed via Pub Med, and searched for published studies that analyzed MMP-9 and TIMP levels in patients with asymptomatic and symptomatic internal carotid stenosis and/or examined these parameters as potential risk markers for ischaemic stroke. A total of 13 articles documenting the outcomes of patients with symptomatic or asymptomatic carotid stenosis treated by carotid stenting or endarterectomy, were analyzed. Statistically significant differences in the levels of MMP-9 and/or TIMP in patients with symptomatic and asymptomatic CS have been reported. Also the concentrations of MMP-9 and TIMP in CS patients subjected to stenting or endarterectomy were higher than in baseline group. Moreover higher levels of MMP-9 and decreased TIMP was reported to be associated with the risk of restenosis. This systematic review shows that available evidence regarding the dynamics of MMP-9 and TIMP levels may be a predictor of cerebrovascular events in both symptomatic and asymptomatic carotid stenosis in patients treated with stenting or endarterectomy.
我们仍然缺乏一种理想的工具来预测有症状和无症状颈动脉狭窄（CS）患者的缺血性中风。已经表明，可以根据血浆中金属蛋白酶（MMPs）水平升高和金属蛋白酶组织抑制剂（TIMP）活性降低来识别缺血性中风风险增加的患者。很少有研究阐述MMP-9和TIMP在接受支架置入术或动脉内膜切除术治疗的有症状和无症状CS患者缺血性中风中的作用，然而我们尚未发现任何已发表的综述总结上述标志物的作用。通过Pub Med访问MEDLINE，并搜索已发表的研究，这些研究分析了无症状和有症状颈内动脉狭窄患者的MMP-9和TIMP水平，和/或将这些参数作为缺血性中风的潜在风险标志物进行检测。总共分析了13篇记录接受颈动脉支架置入术或动脉内膜切除术治疗的有症状或无症状颈动脉狭窄患者结局的文章。有报道称，有症状和无症状CS患者的MMP-9和/或TIMP水平存在统计学上的显著差异。此外，接受支架置入术或动脉内膜切除术的CS患者的MMP-9和TIMP浓度高于基线组。此外，据报道，较高的MMP-9水平和降低的TIMP与再狭窄风险相关。这项系统综述表明，关于MMP-9和TIMP水平动态变化的现有证据可能是接受支架置入术或动脉内膜切除术治疗的有症状和无症状颈动脉狭窄患者脑血管事件的预测指标。
