The Dynamic Changes Of MMP-9and TIMP-1in Plasma And The Effect Of Xingnaojing After Intracerebral Hemorrhage

Intracerebral hemorrhage has a high morbidity and mortality. It affects the quality of lifeof the patients seriously. The edema is considered as one of the main reasons that causeneurological dysfunction. Studies at home and abroad have shown that Matrixmetalloproteinase-9(MMP-9) is closely related with edema after intracerebral hemorrhage.Tissue inhibitor of metalloproteinase-1(TIMP-1) is a specific inhibitor of MMP-9, andinhibits the activity of MMP-9,the unbalance of MMP-9and TIMP-1after intracerebralhemorrhage causes edema. The current research on expression of TIMP-1after intracerebralhemorrhage is rare, and did not come to the same conclusion. Therefore study on theexpression of MMP-9and TIMP-1after intracerebral hemorrhage,and search for a kind ofmedicine blocking the ways edema occurrence and development becomes a new direction forthe treatment of intracerebral edema.Objectives:To observe the dynamic change of plasma MMP-9,TIMP-1after acuteintracerebral hemorrhage and their relationships with cerebral edema; To discuss the effect ofXingnaojing on MMP-9and TIMP-1,and to speculate possible mechanisms of reducingedema of Xingnaojing.Methods:69patients of intracerebral hemorrhage were divided into conventionaltreatment group and Xingnaojing group,16healthy patients as the normal control group. Theconventional treatment group treated with dehydration drugs for the therapy according to theamount of bleeding. Xingnaojing treatment group treated with Xingnaojing on the basis of theuse of dehydration drugs. To test plasma MMP-9and TIMP-1content within24hours,5days,14days respectively. Performing CT Within24hours and14days, calculating the volume ofcerebral edema.Results:Plasma MMP-9level of healthy people was (53.76±9.76) ng/ml. MMP-9level of all patients with intracerebral hemorrhage were significantly higher within24hours (p<0.01), it was positively correlated with cerebral edema volume, conventional treatmentgroup (r=0.857, p<0.01), Xingnaojing treatment group (r=0.757, P <0.01). MMP-9levelwas up to the peak at5days (P <0.05).It declined to the level of24hours at14days (p>0.05), it was positively correlated with cerebral edema volume, conventional treatmentgroup(r=0.875,p<0.01)，Xingnaojing treatment group（r=0.757，p<0.01）. The MMP-9levelof Xingnaojing treatment group was significantly decreased at each time point compared withthe conventional treatment group(P <0.01).Plasma TIMP-1level of healthy people was (81.19±6.50) ng/ml.TIMP-1level of all patients with intracerebral hemorrhage were significantlyhigher within24hours (p<0.01), it was negative correlated with cerebral edemavolume,conventional treatment group(r=0.548,P=0.01),Xingnaojing treatmentgroup(r=-0.521,P=0.01).TIMP-1level was up to the peak at5days (p<0.05), it significantlydecreased to the level of healthy people at14days (p>0.05). The TIMP-1level ofXingnaojing treatment group was elevated at each time point compared with the conventionaltreatment group (P <0.05).MMP-9and TIMP-1levels were negative correlated within24hours (r=-0.626, P<0.05),they were positive correlated at5days (r=0.909, P <0.01),they have no correlation at14days of conventional treatment group. MMP-9and TIMP-1levels were negativecorrelated within24hours (r=-0.355，p<0.05),they were positive correlated at5days(r=0.456，p<0.05),they have no correlation at14days of Xingnaojing treatment group.Conclusion:1. The levels of MMP-9increased within24hours, it got to the peak at5days, and declined to the levels of24hours at14days. The levels of TIMP-1increased within24hours,it got to the peak at5days, and declined to the levels of healthy people at14days.They suggest MMP-9may be involved in the whole process of brain edema.TIMP-1mayreflect early edema, and has nothing to do with the delayed edema.2. MMP-9levels andedema volume were positively correlated, TIMP-1levels and edema volume were negativelycorrelated of patients with cerebral hemorrhage. MMP-9is more relevant and better reflectthe degree of cerebral edema.3. The expression of MMP-9and TIMP-1were negativelycorrelated within24hours,and were positively correlated at5days.We speculated that usageof some drug with the function of increasing TIMP-1or reduceing MMP-9levels may reduceedema in the early period of intracerebral hemorrhage.4.Xingnaojing may reduce the edema of intracerebral hemorrhage by reducing plasma MMP-9levels, elevated TIMP-1levels,andit starts within24hours，using Xingnaojing in the early stage of intracerebral hemorrhagemay reduce edema.