9、C-反应蛋白临床意义的研究.docVIP

9、C-反应蛋白临床意义的研究 ? 1414? (~ 豳 Ch 曲 ine祷seGeneralP I racticne 急性脑梗死患者血清基质金属蛋白酶一9,C一反应蛋白 临床意义的研究 周志斌,李小好,牛建平,蒋春,王思鸿,丁秋华 ? 论着? 【摘要】目的研究缺血性脑卒中患者急性期血清基质金属蛋白酶一9(MMP一9),c一反应蛋白(CRP)水平 与脑梗死病灶体积大小以及预后的关系,并探讨其潜在的机制.方法对124例缺血性脑卒中患者在起病24h内抽取 肘静脉血,用酶联免疫吸附测定法测定MMP一9水平,同时用免疫比浊法测定CRP水平.根据脑卒中患者临床神经功 能缺损程度评分标准对患者入院以及入院3周后进行评分,患者均进行CT/MRI检查确诊.结果3组受检者MMP一 9,CRP,三酰甘油及白细胞数间差别均有显着性意义(Plt;0.01);CRP异常组和正常组脑梗与腔梗构成比,病死率, 治疗有效率,MMP一9水平间差剐均有显着性意义(Plt;0.O1),CRP异常患者中,高MMP一9组与非高MMP一9组脑 梗与腔梗构成比,治疗有效率间差别均有显着性意义(Plt;0.05),病死率间差别无显着性意义(Pgt;0.05).MMP一 9水平与CRP水平呈直线正相关(r=0.224,P:0.O13),与预后呈等级正相关(r=0180,P=0.046).结论脑 梗死急性期血清MMP一9,CRP水平与缺血性脑卒中有关,对于梗死体积大小以及近期预后的判断有一定的临床意义. 【关键词】脑血管意外;基质金属蛋白酶一9;C一反应蛋白质;预后 【中图分类号】R743.3【文献标识码】A【文章编号】1007—9572(2006)17—1414—03 ClinicalSignificanceofMatrixMetalloproteinases一9.C—ReactionProteininAcuteCerebralInfarctionZHOUZhi— bin,LIXiao—hao,NIUJian—ping,eta1.e.3PeoplesHospitalofChangzhou,Changzhou213001,China 【Abstract】ObjecfiveToinvestigatetherelationofmatrixmetalloproteinases一9(MMP一9)andC—reactivepro. tein(CRP)concentrationswiththesizeofcerebralinfarctionfocusandtheprognosisincerebralischemics~oke.MethodsA totalof124patientswithacutecerebralischemicstrokewereenrolled.SerumMMP一9andCRPlevelsweredeterminedbyen. zyrme——linkedimmunosorbentassayandimmuneturbidimetryrespectivelyinbloodsamplesobtainedwithin24hoursofischemic stroke.Allpatientswerescoredbytheassessmentstandardofclinicalnervousfunctionaldefectdegree(CNFD),andidentified bycomputedtopographyandmagneticresonanceimagingexamination.ResultsSerumMMP一9,CRPandtriglyceridelevels, andleukocytecountatadmissionweresignificantlyhigherintheterritoryinfarctiongroupthanthoseinthelacunarinfarctiongroup (Plt;0.O1).InthegroupofelevatedCRP,serumMMP一9level,mortality,componentratioofterritoryinfarctionandthela— cunarinfarctionwerehigher;whilethetherapeuticefficacywasworsethanthoseinnormalCRPgroup(Plt;0.01).Thecompo— nentratioofterritoryinfarctionwashigherinhighMMP-9groupthanthatinnon—highMMP一9group(Plt;0.05);whilethe therapeuticefficacywasworse(P