Characterisation of DWI-MRI confirmed cerebral infarcts in patients with subarachnoid haemorrhage and their association with MMP-9 levels
Characterisation of DWI-MRI confirmed cerebral infarcts in patients with subarachnoid haemorrhage and their association with MMP-9 levels
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DOI：
10.1179/1743132815y.0000000045
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发表时间：
2015-08-01
影响因子：
1.9
通讯作者：
Parkhutik, Vera
中科院分区：
文献类型：
--
作者：
Lago, Aida;Ignacio Tembl, Jose;Parkhutik, Vera
目的：研究提示金属蛋白酶-9 （MMP-9）可预测蛛网膜下腔出血（SAH）后脑血管痉挛的发生。本研究的目的是分析SAH患者MRI缺血性梗死患者与非MRI缺血性梗死患者之间的差异，并研究金属蛋白酶作为缺血性梗死预后因素的作用。方法：连续68例SAH患者，在SAH后3周进行弥散加权磁共振成像（DWI-MRI）检查。我们定义了两组，有和没有DWI-MRI梗死。入厂时采血，第3天和第1周采用ELISA法检测MMP-9。结果：40%为男性，平均年龄54±14岁。DWI-MRI梗死25例，占36.8%；MRI梗死患者中，SAH更严重（Fisher= 4.52 vs 25.6%， P=0.037），发病率-死亡率更高（Rankin bbb3.48 vs 18.6%， P=0.014），更有症状性血管痉挛（28 vs 7%， P=0.031）。MMP-9水平高于对照组，但有梗死和无梗死患者之间无显著差异（首次测定无梗死39.40 ng/ml +/- 35.40 vs梗死49.75 ng/ml +/- 34.54， P>0.005, 3天无梗死72.10 ng/ml +/- 70.95 vs梗死62.28 +/- 33.84，P>0.005, 1周无梗死148.48 ng/ml +/- 142.73 vs梗死91.51 ng/ml +/- 41.20， P>0.005）。结论：在一系列研究充分的SAH患者中，38%的患者有DWI-MRI梗死；梗死与SAH严重程度、SAH结局和症状性血管痉挛相关。金属蛋白酶-9在SAH患者中高于对照组，但不能区分梗死患者。
Objectives: It has been suggested that metalloproteinase-9 (MMP-9) could predict the onset of cerebral vasospasm after subarachnoidal haemorrhage (SAH). The aim of this study was to analyse, in patients with SAH, the difference between patients with MRI ischaemic infarcts and patients without, and to investigate the role of metalloproteases as a prognostic factor for ischaemic infarcts.Methods: Sixty eight consecutive patients with SAH and diffusion-weighted magnetic resonance imaging (DWI-MRI) done 3 weeks after SAH. We define two groups, with and without DWI-MRI infarcts. Blood samples were taken at entry, 3 days and 1 week MMP-9 was determined through ELISA method.Results: Forty per cent were male, with a mean age of 54 +/- 14 years. Twenty five patients, 36.8%, had DWI-MRI infarcts; in patients with MRI infarcts, SAH was more severe (Fisher=4 52 vs 25.6%, P=0.037), with more morbi-mortality (Rankin>3 48 vs 18.6%, P=0.014), and more symptomatic vasospasm (28 vs 7%, P=0.031). Levels of MMP-9 were higher than controls, but there were no significant differences between patients with and without infarcts (first determination no infarcts 39.40 ng/ml +/- 35.40 vs infarcts 49.75 ng/ml +/- 34.54, P>0.005, 3 days no infarcts 72.10 ng/ml +/- 70.95 vs infarcts 62.28 +/- 33.84, P>0.005, 1 week no infarcts 148.48 ng/ml +/- 142.73 vs infarcts 91.51 ng/ml +/- 41.20, P>0.005).Conclusion: Thirty eight percent in a well-studied series of patients with SAH have DWI-MRI infarcts; the infarcts were associated to SAH severity, SAH outcome and symptomatic vasospasm. Metalloproteinase-9 was higher in SAH patients than in controls, but it could not discriminate the infarct patients.