MMP-2、MMP-9在自發(fā)性蛛網(wǎng)膜下腔出血患者血清中的表達(dá)與腦血管痙攣的相關(guān)性研究
發(fā)布時(shí)間：2018-08-03 13:14
【摘要】：目的： 本研究是分析基質(zhì)金屬蛋白酶-2（MMP-2）和基質(zhì)金屬蛋白酶-9在腦動(dòng)脈瘤破裂患者術(shù)后4-14天外周血清濃度的變化與腦血管痙攣的關(guān)系，從而探討它們作為腦動(dòng)脈瘤破裂蛛網(wǎng)膜下腔出血患者術(shù)后腦血管痙攣嚴(yán)重程度指標(biāo)的可能。 方法： 采用明膠酶譜法對(duì)35例經(jīng)手術(shù)治療破裂的腦動(dòng)脈瘤（開(kāi)顱夾閉術(shù)和介入栓塞術(shù)）患者自發(fā)病后第四天起隔天連續(xù)采取外周血樣本進(jìn)行分析，并對(duì)門(mén)診健康志愿者在同一時(shí)間采血分析，用醫(yī)學(xué)圖像系統(tǒng)進(jìn)行定量計(jì)算，同時(shí)對(duì)手術(shù)患者行經(jīng)顱多普勒超聲檢測(cè)，判斷腦血管痙攣程度并與MMP-2、MMP-9表達(dá)水平進(jìn)行比較。 結(jié)果： 腦動(dòng)脈瘤破裂引起自發(fā)性蛛網(wǎng)膜下腔出血患者血清中MMP-2和MMP-9值高于正常人且MMP-9升高水平更為明顯，并且與正常組對(duì)比，，MMP-2與MMP-9均有統(tǒng)計(jì)意義（P＜0.05），而且MMP-9有顯著差異（P＜0.01），其中，MMP-9表達(dá)水平的變化程度與腦血管痙攣嚴(yán)重程度有臨床相關(guān)（P＜0.01），MMP-2的變化程度與腦血管痙攣嚴(yán)重程度無(wú)臨床相關(guān)（P＞0.05）；多發(fā)腦動(dòng)脈瘤破裂患者血清中MMP-2、MMP-9表達(dá)水平與單發(fā)腦動(dòng)脈瘤患者血清中MMP-2、MMP-9表達(dá)水平比較無(wú)臨床相關(guān)（P＞0.05）；不同性別患者血清中MMP-2、MMP-9表達(dá)水平比較無(wú)臨床相關(guān)（P＞0.05）；不同年齡患者血清中MMP-2、MMP-9表達(dá)水平比較無(wú)臨床相關(guān)（P＞0.05）；行腦動(dòng)脈瘤開(kāi)顱夾閉術(shù)患者血清中MMP-9表達(dá)水平與行腦動(dòng)脈瘤介入治療患者血清中MMP-2、MMP-9表達(dá)水平比較無(wú)臨床相關(guān)(P＞0.05)；血清MMP-9表達(dá)水平在第4天起上升，并在第6-8天達(dá)到高峰，此后逐漸下降，第14天左右表達(dá)水平較正常值稍高，MMP-2在第4天即出現(xiàn)高表達(dá)，隨后稍微下降，第8-10天左右再次達(dá)到高峰，并逐漸下降，但第14天左右表達(dá)水平仍較正常值高。 結(jié)論： 血清MMP-2、MMP-9表達(dá)水平在腦動(dòng)脈瘤破裂患者中明顯升高，且MMP-9表達(dá)水平變化與動(dòng)脈瘤患者腦血管痙攣程度呈正相關(guān)；MMP-2雖也呈高表達(dá)，但與腦血管痙攣程度無(wú)明顯相關(guān)性。MMP-9的表達(dá)水平有望成為腦動(dòng)脈瘤破裂引起自發(fā)性蛛網(wǎng)膜下腔出血患者腦血管痙攣的診斷指標(biāo)，并為后續(xù)治療方案提供指導(dǎo)。
[Abstract]:Objective: to study the relationship between the changes of serum concentration of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) and cerebral vasospasm in patients with ruptured cerebral aneurysms 4-14 days after operation. To explore the possibility of cerebral vasospasm severity in patients with ruptured cerebral aneurysm subarachnoid hemorrhage. Methods: 35 patients with ruptured cerebral aneurysms (craniotomy and interventional embolization) were analyzed by gelatinase spectrum. Blood samples were collected from healthy volunteers at the same time and the quantitative calculation was made by medical image system. At the same time, the degree of cerebral vasospasm was judged by transcranial Doppler ultrasound and the expression level of MMP-9 was compared with that of MMP-2. Results: the serum levels of MMP-2 and MMP-9 in patients with spontaneous subarachnoid hemorrhage caused by rupture of cerebral aneurysm were higher than those in normal controls and the level of MMP-9 was higher than that in normal controls. Compared with normal group, MMP-2 and MMP-9 had statistical significance (P < 0. 05), and MMP-9 had significant difference (P < 0. 01). The change of MMP-9 expression was related to the severity of cerebral vasospasm (P < 0. 01). The severity of spasm had no clinical correlation (P > 0.05). There was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with multiple ruptured cerebral aneurysms (P > 0.05), there was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with multiple aneurysms (P > 0.05), and there was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with multiple aneurysms (P > 0.05). There was no clinical correlation between the expression of MMP-2 and MMP-9 in serum of patients with different ages (P > 0. 05), and there was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with intracranial aneurysm closure and interventional therapy (P > 0. 05). The expression of MMP-9 in serum increased on the 4th day, reached its peak at 6-8 days, then decreased gradually. On the 14th day, the expression of MMP-2 was a little higher than the normal value, and the expression of MMP-2 increased on the 4th day, and then decreased slightly. On the 8th to 10th day, the expression reached the peak again, and gradually decreased, but the expression level was still higher than the normal value on the 14th day. Conclusion: the expression of MMP-2 and MMP-9 in patients with ruptured cerebral aneurysms was significantly increased, and the expression of MMP-9 was positively correlated with the degree of cerebral vasospasm in patients with cerebral aneurysms. However, the expression of MMP-9 in patients with spontaneous subarachnoid hemorrhage caused by rupture of cerebral aneurysm is expected to be the diagnostic index of cerebral vasospasm, and it may provide guidance for the treatment of cerebral vasospasm in patients with spontaneous subarachnoid hemorrhage caused by rupture of cerebral aneurysms.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R743.35
本文編號(hào)：2161855
[Abstract]:Objective: to study the relationship between the changes of serum concentration of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) and cerebral vasospasm in patients with ruptured cerebral aneurysms 4-14 days after operation. To explore the possibility of cerebral vasospasm severity in patients with ruptured cerebral aneurysm subarachnoid hemorrhage. Methods: 35 patients with ruptured cerebral aneurysms (craniotomy and interventional embolization) were analyzed by gelatinase spectrum. Blood samples were collected from healthy volunteers at the same time and the quantitative calculation was made by medical image system. At the same time, the degree of cerebral vasospasm was judged by transcranial Doppler ultrasound and the expression level of MMP-9 was compared with that of MMP-2. Results: the serum levels of MMP-2 and MMP-9 in patients with spontaneous subarachnoid hemorrhage caused by rupture of cerebral aneurysm were higher than those in normal controls and the level of MMP-9 was higher than that in normal controls. Compared with normal group, MMP-2 and MMP-9 had statistical significance (P < 0. 05), and MMP-9 had significant difference (P < 0. 01). The change of MMP-9 expression was related to the severity of cerebral vasospasm (P < 0. 01). The severity of spasm had no clinical correlation (P > 0.05). There was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with multiple ruptured cerebral aneurysms (P > 0.05), there was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with multiple aneurysms (P > 0.05), and there was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with multiple aneurysms (P > 0.05). There was no clinical correlation between the expression of MMP-2 and MMP-9 in serum of patients with different ages (P > 0. 05), and there was no clinical correlation between the expression of MMP-2 and MMP-9 in patients with intracranial aneurysm closure and interventional therapy (P > 0. 05). The expression of MMP-9 in serum increased on the 4th day, reached its peak at 6-8 days, then decreased gradually. On the 14th day, the expression of MMP-2 was a little higher than the normal value, and the expression of MMP-2 increased on the 4th day, and then decreased slightly. On the 8th to 10th day, the expression reached the peak again, and gradually decreased, but the expression level was still higher than the normal value on the 14th day. Conclusion: the expression of MMP-2 and MMP-9 in patients with ruptured cerebral aneurysms was significantly increased, and the expression of MMP-9 was positively correlated with the degree of cerebral vasospasm in patients with cerebral aneurysms. However, the expression of MMP-9 in patients with spontaneous subarachnoid hemorrhage caused by rupture of cerebral aneurysm is expected to be the diagnostic index of cerebral vasospasm, and it may provide guidance for the treatment of cerebral vasospasm in patients with spontaneous subarachnoid hemorrhage caused by rupture of cerebral aneurysms.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R743.35
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 張宇,諸葛啟釧,瞿宣興,趙繼宗,鄭偉明,鐘鳴,吳近森;腦動(dòng)脈瘤病理改變與基質(zhì)金屬蛋白酶(MMPs)的表達(dá)[J];溫州醫(yī)學(xué)院學(xué)報(bào);2003年02期
本文編號(hào)：2161855
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