| 彭宪星,王远波,孙启朋.脑脊液基质金属蛋白酶 -9、白细胞介素 -10表达与蛛网膜下腔出血后脑血管痉挛及预后的相关性研究[J].安徽医药,2025,29(3):615-619. |
| 脑脊液基质金属蛋白酶 -9、白细胞介素 -10表达与蛛网膜下腔出血后脑血管痉挛及预后的相关性研究 |
| Correlation between the expression of MMP-9 and IL-10 in cerebrospinal fluid and cerebral vasospasm and prognosis after subarachnoid hemorrhage |
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| DOI：10.3969/j.issn.1009-6469.2025.03.038 |
| 中文关键词: 蛛网膜下腔出血 脑血管痉挛 基质金属蛋白酶 -9 白细胞介素 -10 预后 |
| 英文关键词: Subarachnoid hemorrhage Cerebral vasospasm Matrix metalloproteinase-9 Interleukin-10 Prognosis |
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| 中文摘要: |
| 目的探讨脑脊液基质金属蛋白酶 -9(MMP-9)、白细胞介素 -10(IL-10)与蛛网膜下腔出血( SAH)后脑血管痉挛( CVS)及预后的相关性。方法选取 2019年 1月至 2021年 3月枣庄矿业集团中心医院收治的 201例 SAH病人作为研究对象，根据是否发生 CVS将所有病人分为非 CVS组(92例)CVS组(109例)；根据 CVS病人随访 90 d后改良 Rankin量表(mRS)评分将所有病人分为预后良好组(0~2分， 66例)和预后不良组(，3~6分， 43例)。采用酶联免疫吸附测定( ELISA)法检测所有病人脑脊液 MMP-9、 IL-10的表达水平； Pearson法分析 CVS病人脑脊液 MMP-9与 IL-10表达水平的相关性；使用受试者操作特征曲线( ROC曲线)分析 MMP-9、IL-10对 CVS病人预后不良的预测价值；采用多因素 logistic回归分析影响 CVS病人预后不良的危险因素。结果入院 1、7、14 d时，非 CVS组病人脑脊液 MMP-9［( 304.64±41.56)μg/L、(325.88±47.12)μg/L、(391.09±56.29)μg/L］表达水平和 CVS组［(438.77±60.90)μg/L、(461.92±58.43)μg/L、(532.74±63.00)μg/L］依次升高( P<0.05)，非 CVS组脑脊液 IL-10［(513.27±60.23) ng/L、(471.05±51.92)ng/L、(442.89±45.58)ng/L］表达水平和 CVS组［( 409.62±49.29)ng/L、(380.26±40.75)ng/L、(351.66±43.21) ng/L］依次降低( P<0.05)；与非 CVS组比较， CVS组病人各时间点脑脊液 MMP-9表达水平均显著升高( P<0.05)，IL-10表达水平均显著降低(P<0.05)。预后不良组病人脑脊液 MMP-9［(621.12±85.85)μg/L、(319.97±44.64)μg/L］表达水平、 Hunt-Hess分级、改良 Fisher分级、脑积水程度、格拉斯哥昏迷( GCS)评分显著高于预后良好组病人，而预后不良组病人脑脊液 IL-10［( 346.93±39.56)ng/L、(450.46±55.63)ng/L］表达水平低于预后良好组病人( P<0.05)。 CVS病人脑脊液 MMP-9与 IL-10表达水平呈负相关(r=.0.57，P<0.05)。 ROC曲线分析显示，脑脊液 MMP-9、IL-10、二者联合预测 CVS病人预后不良的曲线下面积( AUC)分别为 0.84、0.81、0.93，二者联合的 AUC明显高于脑脊液 MMP-9、IL-10单独预测( P<0.05)；多因素 logistic回归分析表明，改良 Fisher分级、 Hunt-Hess分级、 MMP-9高水平、 IL-10低水平是 CVS病人预后不良的独立危险因素( P<0.05)。结论 MMP-9、IL-10的表达与 SAH后 CVS的发生有关，可作为 CVS病人预后评估的辅助指标，且 MMP-9联合 IL-10对评估病人预后更有意义。 |
| 英文摘要: |
| Objective To investigate the correlation between cerebrospinal fluid matrix metalloproteinase-9 (MMP-9), interleukin-10 (IL-10) and cerebral vasospasm (CVS) and prognosis after subarachnoid hemorrhage (SAH).Methods A total of 201 SAH patients ad-mitted to Zaozhuang Mining Group Central Hospital from January 2019 to March 2021 were selected as the research objects. Accordingto whether CVS occurred, all patients were divided into non-CVS group (92 cases) and CVS group (109 cases); according to the modi-fied Rankin scale (mRS) score of CVS patients after 90 days of follow-up, all patients were divided into good prognosis group (0-2 points, 66 cases) and poor prognosis group (3-6 points, 43 cases). Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of MMP-9 and IL-10 in the cerebrospinal fluid of all patients; Pearson method was used to analyze the correlation be-tween the expression levels of MMP-9 and IL-10 in cerebrospinal fluid of patients with CVS; ROC curve was used to analyze the predic-tive value of MMP-9 and IL-10 for poor prognosis of CVS patients; multivariate Logistic regression analysis was used to analyze the riskfactors affecting the poor prognosis of CVS patients.Results At 1, 7 and 14 days after admission, the expression level of MMP-9 in ce-rebrospinal fluid of patients in non-CVS group [(304.64±41.56) μg/L, (325.88±47.12) μg/L, (391.09±56.29) μg/L] and CVS group[(438.77±60.90) μg/L, (461.92±58.43) μg/L, (532.74±63.00) μg/L] increased successively (P<0.05), and the expression level of IL-10 in cerebrospinal fluid of patients in the non-CVS group [(513.27±60.23) ng/L, (471.05±51.92) ng/L, (442.89±45.58) ng/L] and the CVSgroup [(409.62±49.29) ng/L, (380.26±40.75) ng/L, (351.66±43.21) ng/L] decreased successively (P<0.05); compared with the non-CVS group, the expression level of MMP-9 in the cerebrospinal fluid of the CVS group was significantly increased (P<0.05), and the expres-sion level of IL-10 was significantly decreased (P<0.05). The expression level of MMP-9 [(621.12±85.85) μg/L, (319.97±44.64) μg/L], Hunt-Hess classification, modified Fisher classification, hydrocephalus degree, GCS score of patients in the poor prognosis group weresignificantly higher than those in the good prognosis group, while the expression level of IL-10 [(346.93±39.56) ng/L, (450.46±55.63)ng/L] in the cerebrospinal fluid of the poor prognosis group was lower than that in the good prognosis group (P<0.05). There was a nega-tive correlation between the expression of MMP-9 and IL-10 in cerebrospinal fluid of patients with CVS (r=.0.57, P<0.05). ROC curve analysis showed that the area under the curve (AUC) of cerebrospinal fluid MMP-9, IL-10 and their combination in predicting the poorprognosis of CVS patients were 0.84, 0.81 and 0.93 respectively; the AUC of their combination was significantly higher than that of ce-rebrospinal fluid MMP-9 and IL-10 alone (P<0.05). Multivariate Logistic regression analysis showed that modified Fisher classification, Hunt-Hess classification, high level of MMP-9, and low level of IL-10 were independent risk factors for poor prognosis of CVS patients (P<0.05).Conclusion The expression of MMP-9 and IL-10 is related to the occurrence of CVS after SAH, and they can be used asauxiliary indicators for prognostic evaluation of CVS patients, and MMP-9 combined with IL-10 is more meaningful for the prognosis evaluation of patients. |
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