血清IL-18、MMP-9水平与高血压脑出血脑损伤关系的研究

doi:10.3969/j.issn.10073205.2018.09.007

摘要/Abstract

摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗分析血清白细胞介素18（interleukin 18,IL18）、基质金属蛋白酶9（matrix metalloproteinase 9,MMP9）水平与高血压脑出血脑损伤的关系。
〖HTH〗方法〖HTSS〗〖KG*2〗选择高血压脑出血患者140例为研究组，健康志愿者100例为健康组，检测2组血清IL18、MMP9水平。将140例患者根据入院时格拉斯哥昏迷量表（Glasgow Coma Scale,GCS）评分、脑血肿量、有无破入脑室分组，比较不同分组患者IL18、MMP9的水平。根据入院时IL18、MMP9水平分组，将比较高低水平组间治疗3个月后的预后情况。分析入院时患者IL18和MMP9水平与入院时GCS评分、入院时血肿量、治疗后3个月美国国立卫生研究院卒中量表（the National Institutes of Health Stroke Scale,NIHSS）评分、治疗后3个月格拉斯哥预后量表（Glasgow Outcome Scale,GOS）评分和治疗后3个月日常生活能力（Activity of Daily Living,ADL）评分的相关性。
〖HTH〗结果〖HTSS〗〖KG*2〗研究组血清IL18和MMP9水平均明显高于健康组（P＜005）。GCS 9~12分组IL18和MMP9水平高于GCS≥13分组，GCS≤8分组IL18和MMP9水平高于GCS≥13分组和GCS 9~12分组（P＜005）。出血量30~50 mL组IL18和MMP9水平高于出血量＜30 mL组，出血量＞50 mL组IL18和MMP9水平高于出血量＜30 mL组和出血量30~50 mL组（P＜005）。脑室积血组IL18和MMP9水平明显高于脑室未积血组（P＜005）。高IL18组治疗3个月后GOS评分和ADL评分明显低于低IL18组，NIHSS评分明显高于低IL18组（P＜005）。高MMP9组治疗3个月后GOS评分和ADL评分明显低于低MMP9组，NIHSS评分明显高于低MMP9组（P＜005）。相关性分析结果显示，IL18和MMP9水平与入院时GCS评分、治疗后3个月GOS评分和治疗后3个月ADL评分呈负相关（P＜005），与入院时血肿量、治疗后3个月NIHSS评分呈正相关（P＜005）。
〖HTH〗结论〖HTSS〗〖KG*2〗高血压脑出血患者血清IL18和MMP9急速升高，且随着脑损伤程度升高而升高，影响患者预后。

关键词: 颅内出血, 高血压性；白细胞介素18；基质金属蛋白酶9

Abstract: ［Abstract］〓Objective〖HTSS〗〓To analyze the relationship between serum levels of interleukin 18(IL18) and matrix metalloproteinase 9(MMP9) and brain injury of hypertensive cerebral hemorrhage.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The study group was 140 patients with hypertensive cerebral hemorrhage and the health group was 100 healthy volunteers. Serum levels of IL18 and MMP9 in two groups were detected. The 140 patients were divided according to Glasgow Coma Scale(GCS) scores, cerebral hematoma volume, and whether they were broken into ventricles to compare the levels of IL18 and MMP9 in different groups. According to the levels of IL18 and MMP9 at admission, the patients were divided into different groups to compare the prognosis of the high and low level groups after 3 months of treatment. The relationships between serum levels of IL18 and MMP9 at admission and GCS scores at admission, cerebral hematoma volume at admission, the National Institutes of Health Stroke Scale(NIHSS) score at 3 months after treatment, Glasgow Outcome Scale(GOS) score at 3 months after treatment and activity of daily living(ADL) score at 3 months after treatment were analyzed.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓Serum levels of IL18 and MMP9 in study group were higher than that of healthy group（P＜005）. Serum levels of IL18 and MMP9 in GCS 9-12 group were higher than that of GCS≥13 group and serum levels of IL18 and MMP9 in GCS≤8 group were higher than that of GCS≥13 group and GCS 9-12 group（P＜005）. Serum levels of IL18 and MMP9 in bleeding volume 30~50 mL group were higher than that of bleeding volume ＜30 mL group and serum levels of IL18, and MMP9 in bleeding volume ＞50 mL group were higher than that of bleeding volume ＜30 mL group and bleeding volume 30-50 mL group（P＜005）. The levels of IL18 and MMP9 in the ventricle hematocele group were higher than those in the non ventricle hematocele group（P＜005）. The GOS score and ADL score in the high IL18 group at 3 months after treatment were significantly lower than that in the low IL18 group, and NIHSS score was significantly higher than that in the low IL18 group（P＜005）. The GOS score and ADL score in the high MMP9 group at 3 months after treatment were significantly lower than that in the low MMP9 group, and NIHSS score was significantly higher than that in the low MMP9 group（P＜005）. The correlation analysis showed that the levels of IL18 and MMP9 were negatively correlated with the GCS score at admission, GOS score and ADL score at 3 months after the treatment（P＜005） and positively correlated with hematoma volume at admission and NIHSS score at 3 months after treatment（P＜005）.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The serum levels of IL18 and MMP9 was increased rapidly in patients with hypertensive cerebral hemorrhage. And as the degree of brain injury increases, it increases, which affect the prognosis of the patients.

Key words: intracranial hemorrhage, hypertensive, interleukin 18, matrix metalloproteinase 9

张建辉，蔡新汝，李〓鹏，孙晓立，姚志刚，贾蔚娴. 血清IL-18、MMP-9水平与高血压脑出血脑损伤关系的研究[J]. 河北医科大学学报, doi: 10.3969/j.issn.10073205.2018.09.007.

ZHANG Jianhui， CAI Xinru， LI Peng， SUN Xiaoli， YAO Zhigang， JIA Weixian. Relationship between serum levels of IL18 and MMP9 and brain injury of hypertensive cerebral hemorrhage#br#[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.10073205.2018.09.007.

[1]	李海红, 杨建凯（综述）, 宋国智（审校）. 烟雾病出血相关风险因素的研究进展#br# #br# [J]. 河北医科大学学报, 2021, 42(12): 1481-1485.
[2]	张立民, 孙文波, 王旭鹏, 李睿, 王晓东, 王明丽. 早期输注新鲜冰冻血浆对外伤性硬膜下血肿患者术后延迟性颅内血肿的影响[J]. 河北医科大学学报, 2020, 41(11): 1261-1265.
[3]	许光涛1，赵宗茂2,3*，王淑霞1，赵满意1，张征云1，卢利英1. 早期强化控压联合镇静镇痛策略对老年高血压脑出血患者血肿量及NIHSS的影响[J]. 河北医科大学学报, 2018, 38(7): 782-786.
[4]	许光涛1，赵宗茂2，3*，孔亚波1，王江英1，杜〓娟1. 3DSlicer辅助定位微创软通道手术治疗老年高血压脑出血的临床研究[J]. 河北医科大学学报, 2018, 38(6): 658-661.
[5]	刘宏志. 穿刺引流微创术联合术后尿激酶溶解治疗高血压性脑出血患者的效果分析[J]. 河北医科大学学报, 2018, 38(10): 1158-1160,1165.
[6]	王忠,苏宁 *,吴日乐,张义松,张晓军,王俊青. 显微血肿清除术及标准大骨瓣减压术治疗重症大面积脑出血及早期颅骨修补的临床研究[J]. 河北医科大学学报, 2016, 37(8): 903-907.
[7]	刘金英;周琦;姜珏;李世杰. 新生儿颅内出血的超声与 CT 检查对比分析[J]. , 2015, 36(2): 209-209.
[8]	石海平;曾春;张施远;段佳;康东. 神经内镜血肿清除术与立体定向血肿抽吸术治疗高血压性脑出血的随机对照研究[J]. , 2015, 36(1): 9-9.
[9]	赵召霞;高虹;徐运强;刘蓓;王荣霞;潘世扬. 高血压性脑出血患者血浆循环DNA与纤维蛋白原相关性研究[J]. , 2013, 34(3): 253-253.
[10]	高金玲;吕桂玲;胡毅平;蔡娜;王晶晶;梁莉萍;未雪勤. 2种气道湿化方法对重症高血压脑出血气管切开患者的影响[J]. , 2012, 33(5): 507-507.
[11]	乔建勇;张海军;郭伟伦. 高血压脑出血意识状态Ⅲ~Ⅳ级患者的首选术式探讨[J]. , 2012, 33(12): 1386-1386.
[12]	张金花. 脑室内出血侧脑室引流的护理体会[J]. , 2010, 31(8): 1009-1009.
[13]	祁金良;牛建;安晓博;耿宏志. 气管切开对高血压脑出血术后有利因素分析[J]. , 2010, 31(7): 865-865.
[14]	武晓静;王燕. 超声在新生儿颅脑疾病诊断中的应用[J]. , 2008, 29(2): 260-260.

血清IL-18、MMP-9水平与高血压脑出血脑损伤关系的研究

Relationship between serum levels of IL18 and MMP9 and brain injury of hypertensive cerebral hemorrhage#br#

HTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 14

编辑推荐

Metrics

本文评价