Relationship Between ICAM-1 And MMP-9 And The Brain Edema In Patients With Intracerbral Hemorrhage

Objective: To study the relationship between the expressions of MMP-9 and ICAM-1 in brain tissue of human intracerebral hemorrhage (ICH), the dynamic changes of serum MMP-9 and ICAM-1 in patients with intracerbral hemorrhage and the brain edema formation following ICH. To provide theory bases for better therapy methods on the brain edema formation following ICH. The study may offer theoretic supports for the pathogensis of brain damage after intracerebral hemorrhage.Methods:(1)Contents of serum ICAM-1, MMP-9 were detected in 30 basal ganglion ICH patients at 1d, 3d, 7d, 14d after intracerebral hemorrhage respectively,brain hematoma and edema around hematoma volume were measured through CT at the same time, and compared with 30 healthy people surem ICAM-1, MMP-9 contenrs.(2)The tissues taken in the surgeries for pathological diagnosis were fixed,buried by wax and sectioned, and were dyed by H.E and immuno-histochemistry, immuno-histochemistrical dyeing was according to the dyeing procedure given by BOSTE,Wuhan company. Conclusion identification using immuno-histo-chemistrical method: positive cells were those whose cytoplasm exist specific yellow– brown granules and the number of positive cells was counted by multimedia chromatic pathologic microscopic picture analytic system MetaMorph/C5050/BX41.Statistical Management: used SPSS software for statistical management,measurement data taked the form of mean number±standard difference ( x±SD),and compared trail team and control team with t test and correlation- regression analysis. Results:(1)The serum level of ICAM-1 and MMP-9 in patients is significantly higher than that of control group at 3, 7, day after basal ganglion intracerebral hemorrhage(p>0.01 ). The level of ICAM-1 is higher than that of nomal group at 1 day but without significantly different (p>0.05) and it reachs to peak at 7 day and tends to decrease thereafter. However, its level remains significantly higher compared with that of control group even at 14 day. The level of MMP-9 in patient group significantly rises at day 1,and tends to increase thereafter,reachs to peak at 7 day, after that it tends to decrease, at 14 day there is no significant diference than normal group. In 14 days brain edema volume around hematoma progressively enlarge, meanwhile MMP-9 content keeps on the high level during this period.(2)this research showed that in trial team, there were ICAM-1 and MMP-9 expression in brain tissiue aroud hematoma and colletive expression of neuron , vascular endothelial cell, among these, neuron was more obvious.The expression of ICAM-1 and MMP-9 has a distinct up regulation in trial team that was much higher than control team.Conclusions: 1. Serum MMP-9 content shows serial changes in patients with intracerebral hemorrhage. High serum MMP-9 content is harm to the brain edema around the hematoma. There probablely is a correlation between the serum level of ICAM-1 and that of MMP-9.2. ICAM-1 and MMP-9 may be involved in the pathophysiologic process of brain edema after ICH, brain edema after ICH leads to changes of concentrations of ICAM-1 and MMP-9,and aggravate brain damage around the hematoma.3. There exists an up-regulation of ICAM-1, MMP-9 expression in brain tissue around hematoma due to hypertensive intracerebral hemorrhage in human, it may participate leukocytes infiltration of brain tissue around the hematoma, finally leding to inflammatory reaction and secondary brain injury.