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目的了解血清MMP-9、外周血WBC、血脂水平在老年急性脑梗塞患者中的作用及脑梗塞面积、神经功能缺损程度评分的相关性,并评价其临床意义。方法急性脑梗死患者40例,对照组80例来自健康查体者。采用双抗夹心ELISA法测定被研究者血清MMP9-的水平。并给予血常规、血脂等检查。结果①脑梗死患者的MMP-9、WBC的含量在发病24小时内开始上升(与对照组比较※P<0.05),5天时达高峰(※与对照组比较※P<0.01),14天明显下降。②脑梗死患者血清MMP-9含量与梗死灶大小及神经功能缺损程度呈正相关,与白细胞水平(r=0.918,P<0.01)、低密度脂蛋白水平(r=0.762,P<0.05)呈正相关,而与高密度脂蛋白水平呈负相关。结论血清MMP-9、外周血WBC参与了急性脑梗死的病理生理过程。血白细胞、低密度脂蛋白等可影响血清MMP-9的浓度。早期检测MMP-9水平可辅助CT进行早期脑梗塞诊断,并可在CT显示病灶前预测梗死灶体积,有助于评价预后;应用MMP-9抑制剂有可能减少脑梗塞体积。
Objective To understand the role of serum MMP-9, peripheral blood WBC, blood lipid levels in elderly patients with acute cerebral infarction and the correlation between infarct size and neurological deficit score and evaluate its clinical significance. Methods 40 cases of acute cerebral infarction patients, 80 cases of control group from the physical examination. The level of serum MMP9- was measured by double-antibody sandwich ELISA. And given blood, blood lipids and other tests. Results ① The levels of MMP-9 and WBC in patients with cerebral infarction began to rise within 24 hours after onset (* P <0.05 compared with the control group), reached their peak on the 5th day (※ P <0.01 compared with the control group), and significantly increased on the 14th day decline. ② The level of serum MMP-9 in patients with cerebral infarction was positively correlated with the size of infarction and the degree of neurological deficit, and positively correlated with leukocyte level (r = 0.918, P <0.01) and low density lipoprotein level (r = 0.762, P <0.05) , But negatively correlated with high density lipoprotein level. Conclusion Serum MMP-9 and peripheral blood WBC are involved in the pathophysiological process of acute cerebral infarction. Blood leukocytes, low density lipoprotein, etc. can affect the serum concentration of MMP-9. Early detection of MMP-9 levels can assist CT in the diagnosis of early cerebral infarction, and can predict the infarct volume in the CT display lesions before, to help evaluate the prognosis; the application of MMP-9 inhibitors may reduce the volume of cerebral infarction.