摘要
目的探讨急性脑卒中患者血清中基质金属蛋白酶-9(MMP-9)、同型半胱氨酸(Hcy)及脂蛋白(a)[Lp(a)]水平检测的临床意义,分析各指标水平与急性脑卒中患者美国国立卫生研究所脑卒中量表(NIHSS)的相关性,以及与预后的关系。方法选取经影像学检查确诊的急性脑卒中患者203例纳入脑卒中组,其中缺血性脑卒中患者165例,出血性脑卒中患者38例。选择同期体检健康者100例纳入对照组。分别测定急性脑卒中患者入院第2天及健康体检者体检当日的MMP-9、Hcy、Lp(a)等指标水平,记录患者入院时的NIHSS评分,并根据NIHSS评分分为重度组、中度组、轻度组。对所有患者进行6个月的随访观察,记录患者发生不良事件的情况。结果脑卒中组与对照组有高血压史、吸烟史患者比例,空腹血糖、三酰甘油、D-二聚体、Hcy、载脂蛋白(a)、白细胞计数、C反应蛋白、降钙素原、MMP-9、Lp(a)水平比较,差异有统计学意义(P<0.05)。NIHSS评分重度组和中度组的患者血清中的MMP-9、Hcy、Lp(a)水平高于轻度组,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,患者血清MMP-9、Hcy、Lp(a)与NIHSS评分呈显著正相关(r分别为0.572、0.475、0.590,P=0.001)。患者入院时的MMP-9、Hcy、Lp(a)的表达水平与6个月内的不良事件发生率密切相关,是影响脑卒中患者预后的独立危险因素。结论急性脑卒中患者血清MMP-9、Hcy、Lp(a)水平明显升高,且与病情的严重程度及不良事件发生率相关,可在一定程度上反映急性脑卒中严重程度,并用于评估预后。
Objective To investigate the significance of detection of matrix metalloproteinase-9(MMP-9),homocysteine(Hcy)and lipoprotein(a)[Lp(a)]in patients with acute stroke.The relationship between the level of biomarkers and the National Institute of Health Stroke Scale(NIHSS),the prognosis of patients with acute stroke.Methods A total of 203 patients with acute stroke diagnosed by imaging examination were enrolled in stroke group,including 165 patients with ischemic stroke and 38 patients with hemorrhagic stroke.A total of 100 cases who underwent healthy physical examination at the same time were selected as control group.The levels of MMP-9,Hcy,Lp(a)and other indicators of acute stroke patients were measured at the time of admission,those of healthy person were measured at the time of physical examination,and the NIHSS scores of patients admitted to hospital were recorded,and according to the NIHSS score,they were divided into severe group,moderate group and mild group.All patients were followed up for 6 months to record the patient′s serious adverse events.Results The proportion of patients with a history of hypertension and smoking,fasting blood glucose,triglyceride,d-dimer,Hcy,apolipoprotein a,white blood cell count,C-reactive protein,procalcitonin,MMP-9,Lp(a)between stroke group and control group were statistically significant(P<0.05).The levels of MMP-9,Hcy,and Lp(a)in the serum of patients in severe group and moderate goup were higher than those of the mild group(P<0.05).Serum MMP-9,Hcy,Lp(a)and NIHSS scores correlated positively in patients(r=0.572,0.475,0.590,P=0.001).Follow-up of the patients revealed that the expression level of MMP-9,Hcy,and Lp(a)at the time of admission closely related to the incidence of adverse events within 6 months,and were independent risk factors for the prognosis of stroke patients.Conclusion The levels of MMP-9,Hcy and Lp(a)in patients with acute stroke increased significantly,and related to the severity of the disease and the incidence of adverse events,which could reflect the se
作者
杜坤
张洁
项忠伟
张广慧
DU Kun;ZHANG Jie;XIANG Zhongwei;ZHANG Guanghui(Department of Clinic Laboratory,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Medical Affair,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)
出处
《国际检验医学杂志》
CAS
2020年第16期1987-1990,共4页
International Journal of Laboratory Medicine
