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重庆市中医院神经外科
纸质出版日期:2017,
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彭形, 罗超, 肖刚, 等. 高血压脑出血患者急性期血清TSP1/2、MMP2/9与脑血肿量及脑水肿量的关系研究[J]. 重庆医科大学学报, 2017,42(12):1649-1652.
Peng Xing, Luo Chao, Xiao Gang, et al. Relationship between serum TSP 1/2,MMP 2/9 and brain hematoma and edema in acute phase of hypertensive intracerebral hemorrhage[J]. Journal of Chongqing Medical University, 2017,42(12):1649-1652.
彭形, 罗超, 肖刚, 等. 高血压脑出血患者急性期血清TSP1/2、MMP2/9与脑血肿量及脑水肿量的关系研究[J]. 重庆医科大学学报, 2017,42(12):1649-1652. DOI: 10.13406/j.cnki.cyxb.001452.
Peng Xing, Luo Chao, Xiao Gang, et al. Relationship between serum TSP 1/2,MMP 2/9 and brain hematoma and edema in acute phase of hypertensive intracerebral hemorrhage[J]. Journal of Chongqing Medical University, 2017,42(12):1649-1652. DOI: 10.13406/j.cnki.cyxb.001452.
目的:探讨高血压性脑出血患者急性期血清血小板反应蛋白1(thrombospondin 1
TSP1)、血小板反应蛋白2(throm bospondin 2
TSP2)、基质金属蛋白酶2(matrix metalloproteinase 2
MMP2)及基质金属蛋白酶9(matrix metalloproteinase 9
MMP9)的水平变化及其临床意义。方法:收集52例发病24 h以内确诊急性脑出血患者为研究组(或急性脑出血组)
同期测量52例正常人血清浓度为正常值;于发病1、3、7、14 d行CT平扫检查
应用体视学法测量患者脑血肿量和脑水肿量;并抽取病人静脉血
酶联免疫法测定血清中TSP1/2和MMP2/9的含量。结果:(1)急性脑出血各时间点血清含量与正常值比较
各时间点血清TSP1/2及MMP2/9含量均明显增高:血清TSP1和TSP2含量分别在第3天[(358.36±20.58)
P=0.000]和第14天[(358.8±17.09)
P=0.000]达到高峰;脑出血后第3天
血清MMP2[(454.23±43.34)
P=0.000]、MMP9[(589.24±56.65)
P=0.000]含量达高峰。(2)脑水肿量于发病后第7天达高峰[(38.85±4.19)
P=0.000]
脑血肿量自病发后逐渐降低。(3)血清TSP2含量表达变化与血清MMP9含量表达变化呈弱负相关(r=-0.14
P=0.041)
血清TSP2含量与脑血肿量负相关(r=-0.57
P=0.000)
血清MMP9含量表达变化与脑血肿量改变呈正相关(r=0.73
P=0.000)
血清MMP2含量表达变化与脑水肿量改变呈正相关(r=0.79
P=0.000)
血清MMP9含量表达变化与脑水肿量改变呈正相关(r=0.73
P=0.000)。结论:脑出血后TSP可能通过调控MMP的表达水平来影响脑血肿量及出血灶周围水肿程度。
Objective:To investigate the change level of thrombospondin 1/2(TSP1/2)and matrix metalloproteinase 2/9(MMP2/9)in patients with acute hypertensive intracerebral hemorrhage(HICH)and its clinical significance.Methods:The 52 patients with HICH within 24 hours from onset diagnosed with head CT as experimental group and 52 cases of physical examination in the same period were collected as the normal value prospectively.In HICH group
brain hematoma volume and edema volume were calculated by CT detection
and TSP1/2 and MMP2/9 levels in serum were determined on days 1
3
7
14 after onsets.Results:(1)The level of TSP1/2 and MMP2/9 in serum of the HICH group was significantly increased than the normal value at each time point.TSP1 and TSP2 reached the peak on the 3 d [(358.36 ±20.58)
P=0.000] and 14 d [(358.8±17.09)
P =0.000] respectively after intracerebral hemorrhage.The serum level of the MMP2[(454.23±43.34)
P=0.000] and the MMP9[(589.24±56.65)
P=0.000] reached the peak on 3 d after intracerebral hemorrhage.(2)The cerebral edema volume reached the peak on 7 d[(38.85±4.19)
P=0.000] after intracerebral hemorrhage
but the brain hematoma volume gradually decreased after illness.(3)The serum level of TSP2 was in weak negative correlation with the serum level of MMP9 after intracerebral hemorrhage(r=-0.14
P=0.000);the serum level of TSP2 was negatively related to the brain hematoma(r=-0.57
P=0.000);the serum level of MMP9 was positively related to the brain hematoma(r=0.73
P=0.000);the serum level of MMP2(r=0.79
P=0.000)and MMP9(r=0.73
P=0.000)were positively related to the cerebral edema.Conclusion:The TSP may affects cerebral hematoma volume and edema surrounding bleeding through regulating MMP expression level after cerebral hemorrhage.
脑出血血小板反应蛋白基质金属蛋白酶脑水肿
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