[1]易震 莫云 葛北海等.急性脑梗死患者静脉溶栓后血清EPO,MMP-9水平与短期预后的相关性研究[J].卒中与神经疾病杂志,2021,28(02):158-161.[doi:10.3969/j.issn.1007-0478.2021.02.005]
　Yi Zhen,Mo Yun,Ge Beihai,et al.The correlation between serum EPO and MMP-9 levels and short-term prognosis after intravenous thrombolysis in patients with acute cerebral infarction[J].Stroke and Nervous Diseases,2021,28(02):158-161.[doi:10.3969/j.issn.1007-0478.2021.02.005]
点击复制

急性脑梗死患者静脉溶栓后血清EPO,MMP-9水平与短期预后的相关性研究()
分享到：

《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第28卷
期数:
2021年02期
页码:
158-161
栏目:
论 著
出版日期:
2021-04-20

文章信息/Info

Title:
The correlation between serum EPO and MMP-9 levels and short-term prognosis after intravenous thrombolysis in patients with acute cerebral infarction
文章编号:
1007-0478(2021)02-0158-05
作者:
易震 莫云 葛北海等
545005 广西柳州市广西壮族自治区脑科医院神经内科[易震 莫云(通信作者)葛北海 徐国龙]
Author(s):
Yi Zhen;  Mo Yun;  Ge Beihai;  et al.
Department of Neurology, Brain Hospital of Guangxi Zhuang Autonomous Region, Liuzhou Guangxi 545005
关键词:
急性脑梗死 静脉溶栓 促红细胞生成素 基质金属蛋白酶-9 短期预后 相关性
Keywords:
Acute cerebral infarction Intravenous thrombolysis Erythropoietin Matrix metalloproteinase-9 Short-term prognosis Correlation
分类号:
R743.3
DOI:
10.3969/j.issn.1007-0478.2021.02.005
文献标志码:
A
摘要:
目的 分析急性脑梗死(Acute cerebral infarct,ACI)患者静脉溶栓后血清促红细胞生成素(Erythropoietin,EPO)、基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)水平与短期预后的相关性。方法 选取本院2018年10月-2020年3月收治93例ACI患者,入院后均予以静脉溶栓治疗; 于治疗结束后进行30 d的随访,应用改良Rankin量表(Modified Rankin scale,mRS)评估预后并分组,且检测血清EPO,MMP-9水平; 分析血清EPO,MMP-9水平与ACI患者静脉溶栓后短期预后的相关性。结果 93例ACI患者随访30 d后血清EPO,MMP-9水平均较治疗前降低(P<0.05); 随访结束93例患者不良预后有32例,经单因素、多因素分析显示血清白蛋白低表达、EPO与MMP-9过度表达可能是ACI患者静脉溶栓后短期预后不良的影响因素(OR>1,P<0.05),其中EPO,MMP-9低表达带来的影响较显著,可能作为独立危险因素(OR=1.096～2.129); 经相关性检验显示ACI患者血清EPO与MMP-9水平呈正相关(r=0.370,P<0.05); 绘制ROC曲线发现,静脉溶栓治疗前血清EPO,MMP-9水平预测ACI患者短期预后不良风险的曲线下面积(AUC)均>0.85,有一定预测价值。结论 血清EPO,MMP-9过度表达可能提示ACI患者静脉溶栓后短期预后不良,监测二者水平变化可为ACI患者静脉溶栓后预后不良的早期预测、干预提供依据。
Abstract:
ObjectiveTo analyze the correlation between serum erythropoietin(EPO)and matrix metalloproteinase-9(MMP-9)levels and short-term prognosis after intravenous thrombolysis in patients with acute cerebral infarction(ACI).Methods 93 patients with ACI treated in our hospital from October 2018 to March 2020 with intravenous thrombolytic therapy after admission, 30 d follow-up was performed after treatment, and the modified Rankin scale(mRS)was used to assess the prognosis and grouped. Serum EPO and MMP-9 levels were detected, the correlation between serum EPO and MMP-9 levels and short-term prognosis after intravenous thrombolytic therapy in ACI patients was analyzed.Results The serum EPO and MMP-9 levels of 93 ACI patients were decreased after 30 days of follow-up(P<0.05), after the follow-up, there were 32 patients with poor prognosis among 93 cases, the single factor and multifactor analysis showed that low expression of serum albumin, overexpression of EPO and MMP-9 might be the influencing factors of poor short-term prognosis after intravenous thrombolytic therapy in ACI patients(OR>1, P<0.05),among them the effects of low EPO and MMP-9 levels were more significant and might be used as independent risk factors(OR=2.129,1.096). The correlation test showed that the serum EPO and MMP-9 levels in ACI patients were positively correlated(r=0.370, P<0.05). The ROC curve found that the serum EPO and MMP-9 levels before intravenous thrombolytic therapy predicted that the area under the short-term prognostic adverse risk(AUC)of ACI patients was all> 0.85, which had certain predictive value.Conclusion The overexpression of serum EPO and MMP-9 might indicate the short-term prognostic risk of ACI patients after intravenous thrombolytic therapy. Monitoring the changes of the two parameter levels could provide the basis for early prediction and intervention of poor prognosis after intravenous thrombolytic therapy in ACI patients.

参考文献/References:

[1] 李亮杰,刘志飞,贾啓龙,等.不同时间窗rt-PA静脉溶栓治疗急性脑梗死患者的疗效和预后观察[J].心脑血管病防治,2020,20(1):75-79.
[2] 李娜娜,丰宏林.急性脑梗死患者静脉溶栓治疗及预后的研究进展[J].医学综述,2017,23(16):3221-3225.
[3] 于秀燕,马宝新,李跃荣.促红细胞生成素对重要系统保护作用的研究进展[J].海南医学院学报,2019,25(19):1516-1520.
[4] Pessoa FG, Mady C, Barbosa Keila Cardoso Fonseca, et al. Erythropoietin reduces collagen deposition after myocardial infarction but does not improve cardiac function[J]. Can J Physiol Pharmacol, 2018, 96(6): 541-549.
[5] Choi J, Ha SK, Lim DJ, et al. S100? matrix metalloproteinase-9, d-dimer, and heat shock protein 70 are serologic biomarkers of acute cerebral infarction in a mouse model of transient MCA occlusion[J]. J Korean Neurosurg Soc, 2018, 61(5): 548-558.
[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.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[7] 袁俊亮,张晓丹,李海英,等.smRSq量表在部分中国脑卒中人群中信度和效度的初步研究[J].临床神经病学杂志,2016,29(3):161-163.
[8] 王允,代大伟,范宇威,等.急性脑梗死溶栓治疗的临床进展[J].现代生物医学进展,2017,17(26):5194-5196, 5047.
[9] 周秉博,王晓宏,杨军.急性脑梗死患者重组组织型纤溶酶原激活剂静脉溶栓后出血性转化的危险因素分析[J].中国医科大学学报,2017,46(12):1101-1104, 1110.
[10] Lu G, He QW, Shen Y, et al. Potential biomarkers for predicting hemorrhagic transformation of ischemic stroke[J]. Int J Neurosci, 2018, 128(1): 79-89.
[11] Wang R, Li J, Duan Y, et al. Effects of erythropoietin on gliogenesis during cerebral ischemic/reperfusion recovery in adult mice[J]. Aging Dis, 2017, 8(4): 410-419.
[12] 陈婉莹,吴海琴,樊嘉欣,等.急性脑梗死患者血EPO和血液流变学的相关性研究[J].中风与神经疾病杂志,2019,36(6):493-495.
[13] Von KR, Meister-Langraf RE, Schmid JP, et al. Low self-rated health is related to blood hypercoagulability in patients admitted with acute myocardial infarction[J]. Thromb Haemost, 2018, 118(1): 54-62.
[14] Zhong C, Yang J, Xu T, et al. Serum matrix metalloproteinase-9 levels and prognosis of acute ischemic stroke[J]. Neurology, 2017, 89(8): 805-812.
[15] Duellman T, Chen X, Wakamiya R, et al. Nucleic acid-induced potentiation of matrix metalloproteinase-9 enzymatic activity[J]. Biochem J, 2018, 475(9): 1597-1610.
[16] 孙成铭.急性脑梗死患者血清同型半胱氨酸、基质金属蛋白酶-9、血管内皮生长因子水平变化及意义[J].中国临床医生杂志,2018,46(6):686-688.
[17] Opstad TB, Seljeflot I, B?mer E, et al. MMP-9 and its regulators TIMP-1 and EMMPRIN in patients with acute ST-Elevation myocardial infarction: a NORDISTEMI substudy[J]. Cardiology, 2018, 139(1): 17-24.
[18] Sheikhvatan M, Boroumand MA, Behmanesh M, et al. Association of R279Q and C1562T polymorphisms of matrix metalloproteinase 9 gene and increased risk for myocardial infarction in patients with premature coronary artery disease[J]. J Clin Lab Anal, 2018, 32(1): e22218.
[19] 钱新宇,吕金峰,Bilal M,等.急性脑梗死静脉溶栓后早期神经功能恶化与血清白蛋白水平的关系研究[J].中国医师进修杂志,2019,42(4):318-324.
[20] Paar M, Rossmann C, Nusshold C, et al. Anticoagulant action of low, physiologic, and high albumin levels in whole blood[J]. PLoS One, 2017, 12(8): e0182997.

更新日期/Last Update: 2021-04-20