脑出血急性期血小板反应蛋白、基质金属蛋白酶与脑血肿及脑水肿的关系

樊宝华; 王光宇; 张文川

doi:10.13898/j.cnki.issn.1000-2020.07.006

脑出血急性期血小板反应蛋白、基质金属蛋白酶与脑血肿及脑水肿的关系

Relationship between the serum levels of thrombospondin, matrix metalloproteinase and cerebral hematoma and edema in the acute phase of cerebral hemorrhage

摘要

摘要:
目的探讨脑出血急性期血清基质金属蛋白酶（matrix metalloproteinase，MMP）、血小板反应蛋白（thrombospondin，TSP）与脑水肿、脑血肿的关系。
方法选取急性高血压脑出血病人62例作为观察组，选择同期体检正常人群50名作为对照组。观察组病人发病第1、3、5、7天分别抽取静脉血并分离血清，对照组留取体检抽血，经酶联免疫吸附法检测2组MMP2、MMP9、TSP1、TSP2水平，同期进行脑CT平扫，测量脑血肿及脑水肿体积，并分析血清MMP2、MMP9、TSP1、TSP2水平与脑血肿及脑水肿体积的相关性。
结果观察组病人发病不同时点血清MMP2、MMP9、TSP1、TSP2水平均明显高于对照组（P < 0.01）。观察组病人第3、5、7天MMP2、MMP9、TSP1水平均明显高于第1天（P < 0.01），在第3天达到峰值（P < 0.01），第5、7天逐渐降低（P < 0.01）；TSP2水平随发病时间延长明显上升（P < 0.01）。观察组病人第3、5、7天脑水肿体积均明显高于第1天（P < 0.01），第3天达到峰值（P < 0.01），第5、7天逐渐降低（P < 0.01）；发病第1天脑血肿体积达峰值（P < 0.01），随后逐渐降低（P < 0.01）。相关分析结果显示，脑出血病人血清TSP1、MMP2、MMP9与脑水肿体积均呈明显正相关关系（P < 0.01），与脑血肿体积呈明显负相关关系（P < 0.01）；TSP2水平与脑水肿体积呈明显负相关关系（P < 0.01），与脑血肿体积呈明显正相关关系（P < 0.01）。
结论脑出血急性期血清MMP、TSP与脑水肿体积具有相关性，TSP可能通过对MMP表达水平的调控影响脑血肿及脑水肿程度。

Abstract:
ObjectiveTo study the relationship between the serum levels of matrix metalloproteinase (MMP), thrombospondin (TSP) and cerebral edema and hematoma in acute phase of cerebral hemorrhage.
MethodsSixty-two patients with acute hypertensive cerebral hemorrhage and 50 normal people were divided into the observation group and control group, respectively.The serum in observation group on the 1st, 2nd, 3rd, 5th and 7th day and seventh day of onset and control group at physical examination were collected.The levels of MMP 2, MMP9, TSP1 and TSP2 in two groups were detected using enzyme-linked immunosorbent assay (ELISA).The CT scan of brain in two groups was simultaneously performed to measure the volume of cerebral hematoma and edema.The correlations of the serum levels of MMP 2, MMP9, TSP1 and TSP2 with volume of cerebral hematoma and cerebral edema were analyzed.
ResultsThe serum levels of MMP 2, MMP9 and TSP1 in observation group at different time-points were significantly higher than those in control group (P < 0.01).The levels of MMP2, MMP9 and TSP1 in observation group on the 3rd, 5th and 7th days were significantly higher than that on the 1st day (P < 0.01), reached a peak on the 3rd day (P < 0.01), gradually decreased on the 5th and 7th day (P < 0.01), and the level of TSP2 increased significantly with the duration of onset (P < 0.01).The brain edema volume in observation group on the 3rd, 5th and 7th days were significantly higher than that on the first day (P < 0.01), reached a peak on the 3rd day (P < 0.01), and gradually decreased on the 5th and 7th days (P < 0.01).On the 1st day of onset, the brain hematoma volume reached a peak (P < 0.01), and then gradually decreased (P < 0.01).The results of correlation analysis showed that the serum levels of TSP1, MMP2 and MMP9 were significantly positively correlated with brain edema volume (P < 0.01), and negatively correlated with the cerebral hematoma volume (P < 0.01).The serum level of TSP2 was significantly negatively correlated with brain edema volume (P < 0.01), and positively correlated with the cerebral hematoma volume (P < 0.01).
ConclusionThe serum levels of MMP and TSP in acute phase of cerebral hemorrhage are related to the cerebral edema volume, and the TSP can affect the degree of cerebral hematoma and edema by regulating the expression level of MMP.

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