Matrix metalloproteinase-9 concentration after spontaneous intracerebral hemorrhage
Matrix metalloproteinase-9 concentration after spontaneous intracerebral hemorrhage
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DOI：
10.3171/jns.2003.99.1.0065
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发表时间：
2003-07-01
影响因子：
4.1
通讯作者：
Alvarez-Sabín, J
中科院分区：
文献类型：
--
作者：
Abilleira, S;Montaner, J;Alvarez-Sabín, J
Object.基质金属蛋白酶（MMPs）在某些神经系统疾病中过度表达，其中存在血脑屏障破坏。作者研究了急性脑出血（ICH）患者血清MMP-9浓度及其与血肿周围水肿（PHE）的关系。通过对57例ICH患者入院后（卒中后< 24小时）抽取的样本进行酶联免疫吸附测定，测定血浆中MMP-9和相关蛋白的浓度。根据计算机断层扫描（CT）结果诊断ICH。在基线和随访CT扫描时测量ICH和PHE的体积，同时使用加拿大卒中量表和格拉斯哥昏迷量表评估患者的神经系统状态。MMP-9在脑出血患者中表达增高。在深度ICH病例中，MMP-9与PHE体积（r = 0.53; p = 0.01）和神经功能恶化（237.4与111.3 ng/ml MMP-9; p = 0.04）显著相关。一项针对PHE绝对体积研究的逻辑回归模型显示，ICH体积是一个独立预测因素（比值比[OR] 3.37; 95%置信区间[CI] 1.1-10.3; p = 0.03）。对深度ICH患者的相对PHE体积（绝对PHE体积/ICH体积）的第二次分析表明，唯一与之相关的因素是MMP-9浓度（OR 11.6; 95% CI 1.5-89.1; p = 0.018）。急性自发性脑出血后MMP-9表达增加。在深度ICH患者中，这种增加与PHE和急性期神经系统恶化的发展相关。
Object. Matrix metalloproteinases (MMPs) are overexpressed in the presence of some neurological diseases in which blood-brain barrier disruption exists. The authors investigated the MMP-9 concentration in patients after acute intracerebral hemorrhage (ICH) and its relation to perihematomal edema (PHE).Methods. Concentrations of MMP-9 and related proteins were determined in plasma by performing an enzyme-linked immunosorbent assay of samples drawn after hospital admission (< 24 hours after stroke) from 57 patients with ICH. The diagnosis of ICH was made on the basis of findings on computerized tomography (CT) scans. The volumes of ICH and PHE were measured on baseline and follow-up CT scans at the same time that the patient's neurological status was assessed using the Canadian Stroke Scale and the Glasgow Coma Scale. Increased expression of MMP-9 was found among patients with ICH. In cases of deep ICH, MMP-9 was significantly associated with PHE volume (r = 0.53; p = 0.01) and neurological worsening (237.4 compared with 111.3 ng/ml MMP-9; p = 0.04). A logistic regression model focusing on the study of absolute PHE volume showed ICH volume as an independent predictor (odds ratio [OR] 3.37; 95% confidence interval [CI] 1.1-10.3; p = 0.03). A second analysis of relative PHE volume (absolute PHE volume/ICH volume) in patients with deep ICH demonstrated that the only factor related to it was MMP-9 concentration (OR 11.6; 95% CI 1.5-89.1; p = 0.018).Conclusions. Expression of MMP-9 is raised after acute spontaneous ICH. Among patients with deep ICH this increase is associated with PHE and the development of neurological worsening within the acute stage.