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目的探讨急性脑梗死患者尿激酶动脉溶栓治疗后血浆基质金属蛋白酶-9(Matrix metalloproteinases-9,MMP-9)的变化及临床意义。方法对20例尿激酶动脉溶栓治疗的急性脑梗死患者MMP-9基础值和溶栓后水平进行测定,比较溶栓前后以及与健康对照组血浆MMP-9水平。结果急性脑梗死患者溶栓后MMP-9水平比对照组和基础值显著升高(P<0.05);溶栓后发生出血性转化的患者MMP-9水平较溶栓前有显著增加(P<0.05),与无出血患者相比有增高趋势但无统计学差异;溶栓后完全再通患者MMP-9较基础值明显升高(P<0.05)。结论尿激酶溶栓可能激活了MMP-9,增加溶栓后出血的风险,并且MMP-9可能参与了脑组织缺血再灌注损伤。
Objective To investigate the changes and clinical significance of plasma matrix metalloproteinase-9 (MMP-9) in patients with acute cerebral infarction after urokinase arterial thrombolysis. Methods The basal levels of MMP-9 and the levels of MMP-9 in 20 patients with acute cerebral infarction treated with urokinase arterial thrombolysis were measured. The plasma levels of MMP-9 before and after thrombolysis and in healthy controls were compared. Results The levels of MMP-9 in patients with acute cerebral infarction after thrombolysis were significantly higher than those in the control group and baseline (P <0.05). The levels of MMP-9 in patients with hemorrhagic transformation after thrombolysis were significantly higher than those before thrombolysis (P < 0.05). There was a trend of increase but no significant difference compared with those without hemorrhage. The MMP-9 level of complete recanalization after thrombolysis was significantly higher than the baseline (P <0.05). Conclusion Urokinase thrombolysis may activate MMP-9, increase the risk of hemorrhage after thrombolytic therapy, and MMP-9 may be involved in cerebral ischemia-reperfusion injury.