[1]巩麦林,鲍 洪,安德柱.急性脑出血后血肿腔引流液及外周血THR、MMP-9与脑水肿、神经功能损伤的相关性[J].医学信息,2019,32(24):36-39.[doi:10.3969/j.issn.1006-1959.2019.24.012]
　GONG Mai-lin,BAO Hong,AN De-zhu.Correlation of Dynamic Changes of Thrombin and MMP-9 in Hematoma Cavity Drainage Fluid and Peripheral Blood with Cerebral Edema and Neurological Damage after Acute Cerebral Hemorrhage[J].Medical Information,2019,32(24):36-39.[doi:10.3969/j.issn.1006-1959.2019.24.012]
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急性脑出血后血肿腔引流液及外周血THR、MMP-9与脑水肿、神经功能损伤的相关性()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年24期
页码:
36-39
栏目:
论著
出版日期:
2019-12-15

文章信息/Info

Title:
Correlation of Dynamic Changes of Thrombin and MMP-9 in Hematoma Cavity Drainage Fluid and Peripheral Blood with Cerebral Edema and Neurological Damage after Acute Cerebral Hemorrhage
文章编号:
1006-1959（2019）24-0036-04
作者:
巩麦林; 鲍 洪; 安德柱
（珠海市人民医院神经外科，广东 珠海 519000）
Author(s):
GONG Mai-lin; BAO Hong; AN De-zhu
(Department of Neurosurgery,Zhuhai People’s Hospital,Zhuhai 519000,Guangdong,China)
关键词:
脑出血; 凝血酶; 基质金属蛋白酶-9; 脑水肿; 神经功能损伤
Keywords:
Cerebral hemorrhage;  Thrombin;  Matrix metalloproteinase-9;  Brain edema;  Neurological impairment
分类号:
R743.3
DOI:
10.3969/j.issn.1006-1959.2019.24.012
文献标志码:
A
摘要:
目的 检测急性脑出血后血肿腔引流液及外周血中凝血酶（THR）、基质金属蛋白酶-9（MMP-9）动态变化，观察其与患者脑水肿、神经功能损伤的关系。方法 选择2017年1月~2019年6月我院收治的75例行血肿清除术或血肿钻孔引流术的急性脑出血患者为对象，分别于术后第1、3、7、14天采集外周血及血肿腔引流液，采用酶联免疫吸附法检测外周血及血肿腔引流液中THR、MMP-9表达水平，并测定各时点头颅CT所示脑水肿比值。采用美国国立卫生研究院卒中量表（NIHSS）评估患者术后第1、3、7、14天神经功能损伤情况，判断急性脑出血后血肿腔引流液及外周血中THR、MMP-9表达水平与脑水肿比值、NIHSS评分的相关性。结果 急性脑出血患者术后3、7天血肿腔引流液及外周血中THR、脑水肿比值、MMP-9高于术后1天（P＜0.05），术后14天血肿腔引流液及外周血中THR、脑水肿比值、MMP-9均低于术后1、3、7天（P＜0.05）。术后3、7天血肿腔引流液及外周血中MMP-9高于术后1天（P＜0.05），术后7天血肿腔引流液及外周血中MMP-9低于术后3天（P＜0.05），急性脑出血患者术后3天NIHSS评分高于术后1天（P＜0.05），术后7天NIHSS评分低于术后1、3天（P＜0.05），术后14天NIHSS评分低于术后1、3、7天（P＜0.05），急性脑出血后血肿腔引流液及外周血中THR、MMP-9与脑水肿比值、NIHSS评分均呈正相关（P＜0.05）。结论 脑出血后血肿腔引流液及外周血中THR、MMP-9动态变化与脑水肿、神经功能损伤密切相关，临床应引起足够重视。
Abstract:
Objective To detect the dynamic changes of thrombin (THR) and matrix metalloproteinase-9 (MMP-9) in the drainage fluid of hematoma cavity and peripheral blood after acute cerebral hemorrhage,and to observe its relationship with cerebral edema and neurological damage.Methods A total of 75 patients with acute cerebral hemorrhage who underwent hematoma removal or hematoma drilling drainage were treated in our hospital from January 2017 to June 2019.The peripheral blood was collected on the 1st, 3rd, 7th, and 14th days after surgery.Blood and hematoma cavity drainage fluids were tested for the expression of THR and MMP-9 in peripheral blood and hematoma cavity drainage fluids by enzyme-linked immunosorbent assay,and the brain edema ratios as shown by skull CT at each time point were measured.The National Institutes of Health Stroke Scale (NIHSS) was used to assess the neurological impairment of patients at 1, 3, 7, and 14 days after surgery,and to determine the expression levels of THR and MMP-9 in hematoma drainage fluid and peripheral blood after acute cerebral hemorrhage.Correlation with cerebral edema ratio and NIHSS score.Results Patients with acute cerebral hemorrhage had higher THR, cerebral edema ratio, and MMP-9 in hematoma cavity drainage fluid and peripheral blood at 3 and 7 days after surgery(P＜0.05),and hematoma drainage fluid and peripheral blood at 14 days after surgery.The THR,cerebral edema ratio and MMP-9 were all lower than those at 1, 3, and 7 days after operation(P<0.05).MMP-9 in hematoma cavity drainage fluid and peripheral blood was higher at 3 and 7 days after operation (P <0.05).On the 7th day after operation, the MMP-9 in drainage fluid and peripheral blood of hematomas cavity was lower than that of 3 days after operation (P < 0.05).The NIHSS score of patients with acute cerebral hemorrhage on the 3rd day after operation was higher than that on the 1st day after operation(P<0.05).The NIHSS score at 7 days after surgery was significantly lower than that at 1 and 3 days after surgery(P<0.05),and the NIHSS score at 14 days after surgery was lower than at 1,3,and 7 days after surgery(P<0.05).After acute cerebral hemorrhage, HR and MMP-9 in hematoma cavity drainage fluid and peripheral blood were positively correlated with cerebral edema ratio and NIHSS score(P<0.05).Conclusion The dynamic changes of THR and MMP-9 in hematoma drainage fluid and peripheral blood after intracerebral hemorrhage are closely related to cerebral edema and neurological damage,which should be paid enough attention in clinic.

参考文献/References:

[1]叶丹丹,金婉玲,金灵芝,等.影响高血压性脑出血患者的相关危险因素调查[J].心脑血管病防治,2018,18(5):415-419.[2]朱传明.急诊不典型脑出血60例临床观察[J].心脑血管病防治,2015,15(3):252-253.[3]李昌,唐翠娥,付蓉,等.微创清除颅内血肿降低病灶周围组织谷氨酸水平及BBB通透性[J].重庆医学,2017,46(18):2471-2474.[4]顾双双,张均,韩玲,等.脑出血后迟发性脑水肿与血浆基质金属蛋白酶9等相关因素的分析[J].中国脑血管病杂志,2015,12(6):297-301.[5]Turner RJ,Sharp FR.Implications of MMP9 for blood brain barrier disruption and hemorrhagic transformation following ischemic stroke[J].Front Cell Neurosci,2016,10(5):56-68.[6]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南(2014)[J].中华神经科杂志,2015,48(6):435-444.[7]王金林,黄燕,刘兴宇,等.微创血肿清除术治疗高血压脑出血颅内临床疗效分析[J].中国急救医学,2016,36(S1):123-124.[8]陈刚,程继勇.开颅血肿清除术和钻孔引流术治疗高血压脑出血疗效比较[J].中国神经精神疾病杂志,2016,42(7):431-434.[9]Glymour MM,Berkman LF,Ertel KA,et al.Lesion characteristics,NIH stroke scale, and functional recovery after stroke[J].Am J Phys Med Rehab,2007,86(9):725-733.[10]Lin L,Yihao T,Jun T,et al.A Cannabinoid receptor 2 agonist prevents thrombin-induced blood-brain barrier damage via the inhibition of microglial activation and matrix metalloproteinase expression in rats[J].Transl Stroke Res,2015,6(6):467-477.[11]Min H,Hong J,Cho IH,et al.TLR2-induced astrocyte MMP9 activation compromises the blood brain barrier and exacerbates intracerebral hemorrhage in animal models[J].Mol Brain,2015,8(1):23-36.[12]杨恒,顾宇翔.凝血酶与脑白质损伤的研究进展[J].中国临床神经科学,2015,23(4):470-474.[13]贾文志,赵金超,孙晓立.凝血酶与高血压脑出血脑水肿形成的相关性研究[J].中西医结合心脑血管病杂志,2017,15(7):869-871.[14]Liu CM,Shi BZ,Zhou JS.Effects of thrombin on the secondary cerebral injury of perihematomal tissues of rats after intracerebral hemorrhage[J].Genet Mol Res,2014,13(2):4617-4626.[15]蓝业平,蔡树雄,何晓明,等.微创治疗高血压性脑出血患者血清MMP-9水平的动态变化及其临床意义[J].中国现代医学杂志,2014,24(13):33-36.[16]谢巍,张波,宋世宾,等.大鼠脑出血后AQP-4、IL-6及MMP-9的表达与脑水肿的相关性研究[J].贵州医药,2015,39(8):686-690.[17]郑秋月,陈应柱.凝血酶在脑出血后白质损伤中的作用及其机制[J].国际脑血管病杂志,2017,25(5):449-453.[18]朱燕,朱东亚.脑出血后继发性脑损伤的机制与治疗[J].中国卒中杂志,2019,14(2):97-101.

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更新日期/Last Update: 2019-12-15