血清基质金属蛋白酶-2在急性脑梗死患者TOAST各分型中含量的动态变化及意义
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摘要
目的探讨血清基质金属蛋白酶-2(matrix metalloproteinase-2,MMP-2)在急性脑梗死(acute cerebral infarction,ACI)患者TOAST(Trail of org 10172 inAcute Stroke Treatment)各病因分型中含量的动态变化及意义。
     方法77例ACI患者按照TOAST标准进行病因分型,用ELISA(enzyme linkedimmunosorbent assay)法检测各分型脑梗死患者在发病第24小时,7天的血清MMP-2含量,及与之相匹配的42例正常对照者的血清MMP-2含量。从而比较MMP-2在急性脑梗死患者TOAST各病因分型中的含量动态变化。
     结果TOAST病因分型构成LAA 37.66%,SAA 29.87%,CE 16.88%,SOE 6.49%,SUE9.09%。急性脑梗死组患者发病24小时,7天血清MMP-2水平均高于对照组(P<0.05);TOAST各分型中,SOE、SUE因例数少未作分析,其它各型中,LAA、SAA、CE组血清MMP-2水平高于对照组(P<0.05),其中以LAA组增高显著(P<0.01)。经Logistic回归分析发现MMP-2、胆固醇及收缩压与脑血管病的发生呈正相关。
     结论急性脑梗死患者血清MMP-2水平增高;MMP-2水平随TOAST亚型的不同而变化,在LAA中浓度升高最显著,支持脑梗死不同亚型可能具有不同病因的论点;血清MMP-2在LAA型脑梗死发病过程中起重要作用。
Objective To study the serial measurement and significance of matrix metaloproteinase-2 in serum of acute cerebral infarction patients according to TOAST criteria.
     Methods 77 patients with acute cerebral infarction and 42 healthy individuals were enrolled in this trial.All the patients were classified into five subtypes according to TOAST criteria.Serum MMP-2 level was measured in patients according to TOAST criteria at hour 24 and day 7,and healthy people by ELISA.And then the relationship between MMP-2 level and their TOAST subtypes were analysed.
     Results Of all the patients,37.66%,29.87%,16.88%,6.49%,9.09%were classified as 1 arge-artery atherosclerosis(LAA),small-artery occlusion lacunar(SAA), cardioembolism(CE),stroke of other demonstrated etiology(SOE),stroke of underdemonstrated etiology(SUE).Serum MMP-2 level of patients were significant higher than those of controls(p<0.05);The level of the serum MMP-2 was much higher in patients with LAA SAA and CE than that in controls.As compared with the control group,The level of the serum MMP-2 in patients with LAA was the highest in ACI(P<0.01).serum MMP-2 level of LAA at day 7 were significant higher than those of other subtypes and the control group.
     Conclusions The serum MMP-2 level varied with different subtypes of ACI,specially elevating in subtypes LAA,which surported that the subtypes varied according to different pathogenies.
引文
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