Clinical Research Of Serum Metalloproteinase In Patients With Acute Intracerebral Hemorrhage

Objective:The periphery tissue of hematoncus resulting from intracerebral hemorrhage (ICH)often has secondary brain injury,of which the pathological mechanism is very complex.Recent studies showed that there are area of edematization and secondary ischemic injury around hematoncus after ICH.The study was designed to observe the temporal profile of matrix metalloproteinase-9(MMP-9)and to investigate the relationship between the level of serum MMP-9 and the perihematomal edema volume and the neurologic impairment in patients with ICH and to achieve new methods or some progresses in corresponding therapeutic strategy in this field.Methods:The level of serum MMP-9 in 29 patients with ICH was determined by enzyme-linked immunosorbent assay(ELISA)for at 24h -72h and 10d -14d after onset. The volumes of hematoma and its peripheral edema were measured according to CT scan, the neurologic impairment score was evaluated by the National Institutes Health Stroke Scale(NIHSS)at the two times,respectively.Results:1.Levels of serum MMP-9 were significant higher in the ICH group at each time point after onset than those in the normal control group.2.There was positive correlation between the hematoma volume and the first neurologic impairment scores.3.Levels of serum MMP-9 were not related with hematoma volume and the first NIHSS scores.On the other hand,levels of serum MMP-9 were positively correlated with the perihematomal edema volume.4.Levels of serum MMP-9 were positively correlated with the second NIHSS scores.Conclusions:1.Hematoma has the direct nervous function injury after ICH.The perihematomal edema plays an important role in the secondary brain damage around hematoma after ICH.2.MMP-9 expression is activated after ICH.The increased expression of MMP-9 may be the index of predicting nervous function injury at the early stage after ICH.3.The changes of the contents of MMP-9 in serum of patients with ICH are closely related with perihematomal edema volume.It is postulated that MMP-9 enhance development of perihematomal edema through degrading of the blood brain barrier component substances.4.It showed that the treatment of inhibiting the expression of MMP-9 should be the good method for the best therapeutic efficacy.