注射用丹参多酚酸对进展性脑梗死患者血清MMP-9、S100B、MBP的影响
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摘要
目的探讨急性进展性脑梗死(PCI)患者外周血基质金属蛋白酶-9(MMP-9)、S100蛋白(S100B)、髓鞘碱性蛋白(MBP)水平的变化及其与PCI的相关性;探讨注射用丹参多酚酸对上述血清因子的调节作用。方法选择发病时间在24 h内的急性脑梗死住院患者90例,PCI 60例,非进展性脑梗死(NPCI)30例,借助SAS统计分析软件随机将PCI分为2组,每组30人,对照组给于基础药物(阿司匹林肠溶片100 mg,口服,每日1次;阿托伐他汀钙片20 mg,口服,每晚1次;依达拉奉注射液30 mg,静脉点滴,每日2次);观察组给于基础药物治疗加注射用丹参多酚酸0.13 mg用0.9%氯化钠注射液250 mL溶解后使用,静脉滴注,每日1次;疗程均为14 d。比较PCI组与NPCI组在治疗前血清MMP-9、S100B、MBP水平;比较观察组与对照组在治疗前及治疗14 d后血清MMP-9、S100B、MBP的水平以及美国国立卫生研究院卒中量表(NIHSS)评分。结果治疗前,PCI组血清MMP-9、S100B、MBP的水平显著高于NPCI组(P<0.05);治疗后观察组与对照组血清MMP-9、S100B、MBP水平均明显下降,与治疗前比较差异均具有统计学意义(P<0.05),且观察组较对照组3者水平明显降低,差异有统计学意义(P<0.05);治疗14 d后,与治疗前比较,观察组NIHSS评分明显下降,差异有统计学意义(P<0.05),对照组变化不显著;且治疗后观察组较对照组NIHSS评分明显下降,差异有统计学意义(P<0.05)。结论脑梗死的进展与血清MMP-9、S100B、MBP的水平变化有关;注射用丹参多酚酸可调节血清MMP-9、S100B、MBP的水平达到防止脑梗死进展的作用。
Objective To investigate the changes of MMP-9, S100 B and MBP level in peripheral blood of patients with acute progressive cerebral infarction(PCI) and its correlation with acute progressive cerebral infarction. To investigate the regulatory effect of Salvianolic Acids for Injection on these serum factors. Methods Selection of 90 inpatients with acute cerebral infarction within 24 hours after onset, 60 cases of PCI, 30 cases of non-progressive cerebral infarction(NPCI), PCI was randomly divided into two groups with 30 people in each group by means of SAS statistical analysis software. The patients in control group were given basic drugs(aspirin enteric-coated tablets 100 mg, orally, once a day; atorvastatin calcium tablets 20 mg, orally, once a night;edaravone injection 30 mg, intravenous drip, twice a day). The patients in observation group were given basic drugs plus Salvianolic Acids for Injection 0.13 mg for injection and 0.9% sodium chloride injection 250 mL for dissolution, intravenous drip once a day;the treatment course was both 14 d. The levels of serum MMP-9, S100 B and MBP were compared between the PCI group and the NPCI group before treatment. The serum MMP-9, S100 B and MBP levels were compared between observation and control group before and 14 days after treatment. The score of somatic nerve function defect(NIHSS) were compared between observation and the control group before and 14 days after treatment. Results The serum MMP-9, S100 B and MBP level in PCI group was higher than that in NPCI group(P < 0.05). After treatment, the levels of serum MMP-9, S100 B and MBP in observation and control group were significantly decreased, with statistical significance compared with those before treatment(P < 0.05), and the levels in the observation group were significantly lower than those in control group(P < 0.05). After 14 days of treatment, the NIHSS scores in observation group were significantly decreased compared with those before treatment(P < 0.05). There was no significant change in the control group, and the NIHSS score of observation group was significantly lower than that of control group after treatment(P <0.05). Conclusion The progression of cerebral infarction is related to the level of serum MMP-9, S100 B and MBP and Salvianolic Acids for Injection can regulate the level of serum MMP-9, S100 B and MBP to prevent the progression of cerebral infarction.
Objective To investigate the changes of MMP-9, S100 B and MBP level in peripheral blood of patients with acute progressive cerebral infarction(PCI) and its correlation with acute progressive cerebral infarction. To investigate the regulatory effect of Salvianolic Acids for Injection on these serum factors. Methods Selection of 90 inpatients with acute cerebral infarction within 24 hours after onset, 60 cases of PCI, 30 cases of non-progressive cerebral infarction(NPCI), PCI was randomly divided into two groups with 30 people in each group by means of SAS statistical analysis software. The patients in control group were given basic drugs(aspirin enteric-coated tablets 100 mg, orally, once a day; atorvastatin calcium tablets 20 mg, orally, once a night;edaravone injection 30 mg, intravenous drip, twice a day). The patients in observation group were given basic drugs plus Salvianolic Acids for Injection 0.13 mg for injection and 0.9% sodium chloride injection 250 mL for dissolution, intravenous drip once a day;the treatment course was both 14 d. The levels of serum MMP-9, S100 B and MBP were compared between the PCI group and the NPCI group before treatment. The serum MMP-9, S100 B and MBP levels were compared between observation and control group before and 14 days after treatment. The score of somatic nerve function defect(NIHSS) were compared between observation and the control group before and 14 days after treatment. Results The serum MMP-9, S100 B and MBP level in PCI group was higher than that in NPCI group(P < 0.05). After treatment, the levels of serum MMP-9, S100 B and MBP in observation and control group were significantly decreased, with statistical significance compared with those before treatment(P < 0.05), and the levels in the observation group were significantly lower than those in control group(P < 0.05). After 14 days of treatment, the NIHSS scores in observation group were significantly decreased compared with those before treatment(P < 0.05). There was no significant change in the control group, and the NIHSS score of observation group was significantly lower than that of control group after treatment(P <0.05). Conclusion The progression of cerebral infarction is related to the level of serum MMP-9, S100 B and MBP and Salvianolic Acids for Injection can regulate the level of serum MMP-9, S100 B and MBP to prevent the progression of cerebral infarction.
引文
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[14]郝彦超,苏建.丹参多酚酸对脑梗死患者血液流变学和神经功能的影响[J].中国实用神经疾病杂志, 2014, 17(16):67-68.
[15]黄旭玲.丹参多酚酸对急性脑梗死患者运动和认知功能的影响[J].中国继续医学教育, 2015, 7(28):180-181.
[16]许伟,王春霞,韩辉,等.丹参多酚酸治疗轻中度脑梗死的临床疗效观察[J].临床合理用药杂志, 2015, 8(23):14-15.
[17]李正仪,刘鹤,苗常青.丹参多酚酸盐对大鼠局灶性脑缺血/再灌注损伤NGFF、BDNF表达的影响[A].中华医学会神经病学分会.第十一届全国神经病学学术会议论文汇编[C].长春, 2008.
[2]曹勇军,刘春风.血管内皮生长因子、基质金属蛋白酶-2、-8与动脉粥样硬化斑块不稳定性[J].国外医学(脑血管疾病分册), 2005, 13(10):770-773.
[3] Kokocinska D, Wieczorek P, Partyka R, et al. The diagnostic utility of S-100B protein and TPA in patients with ischemic stroke[J]. Neuro Endocrinol Lett, 2007, 28(5):693-698.
[4] Spescha R D, Klohs J, Semerano A, et al. Post-ischaemic silencing of p66Shc reduces ischaemia/reperfusion brain injury and its expression correlates to clinical outcome in stroke[J]. Eur Heart J, 2015, 36(25):1590-1600.
[5] Lucivero V, Prontera M, Mezzapesa D M, et al. Different roles of matrix metalloproteinases-2 and-9 after human ischaemic stroke[J]. Neurol Sci, 2007, 28(4):165-170.
[6] Worthmann H, Tryc A B, Goldbecker A, et al. The temporal profile of inflammatory markers and mediators in blood after acute ischemic stroke differs depending on stroke outcome[J]. Cerebrovasc Dis, 2010, 30(1):85-92.
[7] Berger R P, Bazaco M C, Wagner A K, et al. Trajectory analysis of serum biomarker concentrations facilitates outcome prediction after pediatric traumatic and hypoxemic braininjury[J].Dev Neurosci,2010,32(5/6):396-405.
[8] Ramos-Fernandez M, Bellolio M F, Stead L G. Matrix metalloproteinase-9 as a marker for acute ischemic stroke:asystematic review[J]. J Stroke Cerebrovasc Dis,2011, 20(1):47-54.
[9] Park K P, Rosell A, Foerch C, et al. Plasma and brain matrix metalloproteinase-9 after acute focal cerebral ischemia in rats[J]. Stroke, 2009, 40(8):2836-2842.
[10] Brouns R, Wauters A, De Surgeloose D, et al.Biochemical markers for blood-brain barrier dysfunction in acute ischemic stroke correlate with evolution and outcome[J]. Eur Neurol, 2011, 65(1):23-31.
[11]桂见军,徐武华.急性缺血性脑卒中外周血生化标志物的研究进展[J].中华神经医学杂志, 2009, 8(1):94-95.
[12] Campagoni A T. Molecular biology of myelin protein from the central nervous system[J]. J Neurochem, 1988, 51:1.
[13] Lamers K J B, Vos P, Verbeek M M, et al. Protein S-100B, neuron-specific enolase(NSE), myelin basic protein(MBP)and glial fibrillary acidic protein(GFAP)in cerebrospinal fluid(CSF)and blood of neurological patients[J]. Brain Res Bull, 2003, 61(3):261-264.
[14]郝彦超,苏建.丹参多酚酸对脑梗死患者血液流变学和神经功能的影响[J].中国实用神经疾病杂志, 2014, 17(16):67-68.
[15]黄旭玲.丹参多酚酸对急性脑梗死患者运动和认知功能的影响[J].中国继续医学教育, 2015, 7(28):180-181.
[16]许伟,王春霞,韩辉,等.丹参多酚酸治疗轻中度脑梗死的临床疗效观察[J].临床合理用药杂志, 2015, 8(23):14-15.
[17]李正仪,刘鹤,苗常青.丹参多酚酸盐对大鼠局灶性脑缺血/再灌注损伤NGFF、BDNF表达的影响[A].中华医学会神经病学分会.第十一届全国神经病学学术会议论文汇编[C].长春, 2008.