Research The Relationship Between Serum MMP-9 And TIMP-1 And Cognitive Impairment In Acute Stage Of Ischemic Stroke

Objective:Mild cognitive impairment(MCI)and Vascular dementia(Va D)are two mainly common categories of post-stroke cognitive impairment(CI).MCI is a transitional state between Va D and normal,and more than half of MCI patients progress to dementia with in 5 years.At present,Va D has become the second most dementia disease after Alzheimer's disease(AD).While ischemic stroke accounts for 80% of cerebrovascular disease.Therefore,it is urgent to find a simple and easy way to predict CI after ischemic stroke,thus preventing and reducing the occurrence of Va D.Matrix metalloproteinase-9(MMP-9)is involved in the pathophysiology of cerebral infarction by degrading extracellular matrix,involved in neuronal injury and apoptosis,tissue inhibitor of metallo-proteinase-1(TIMP-1)is a specific inhibitor that binds specifically to inhibit its effect.Then whether MMP-9 and TIMP-1 are associated with CI after ischemic stroke,the current study has not yet clear.The aim of this study was to evaluate the relationships between CI after ischemic stroke and MMP-9 and it's inhibitor TIMP-1 in the cerebral infarction acute phase,as well as their prediction effect to the CI after ischemic stroke,and to explore other factors that may affect the CI after cerebral infarction.Methods:We collect the first-ever acute ischemic stroke patients from the unit ward of the Chengde medical college affiliated hospital during December 1,2015 to March 31,2016,(Ischemic stroke group,n=84)and healthy volunteers come from medical center as the healthy control(Healthy control group,n=40).Comprehensive clinical information of all object were collected,fasting plasma samples were obtained on the early morning.The plasma concentrations of both MMP-9 and its inhibitor TIMP-1 were measured by ELISA.All object were assessed using the NIHSS?Hachiski?Mo CA 14 days after they into the test.According to Mo CA score results,the ischemic stroke group were divided into cognitive impairment group(Mo CA < 26)and non cognitive impairment group(Mo CA ? 26).Firstly,the levels of serum MMP-9 and TIMP-1 in the cognitive impairment group,the non-cognition impairment group and the healthy control group were compared,and observed their change orientation.Then,through correlation analysis,analysis the correlation of serum concentrations of MMP-9,TIMP-1 and Mo CA score of cognitive impairment group.And then discusses the relationship between serum concentration of MMP-9,TIMP-1 and CI after cerebral infarction and their predictive value to CI after cerebral infarction.Using Logistic regression analysis to investigate the effects of a major risk factor for CI after cerebral infarction.Results:1.A total of 84 patients with ischemic stroke were enrolled in this study,44 cases were divided into CI group,40 cases were divided into NCI group.The average age of CI group was 56.381±7.204 years old,the NCI group was 51.550±7.317 years old.There was no significant difference in sex,hypertension,diabetes,smoking,drinking and education years between the two groups except the age(P>0.05),which indicated the comparability of the data between the two groups.2.Serum MMP-9 levels significantly increased and serum TIMP-1 levels significantly decreased in the CI group and in the NCI group compared to the healthy control levels(P < 0.05,P < 0.05).Serum MMP-9 levels were significantly higher and serum TIMP-1 levels were significantly lower in the CI group compared with the NCI group(P < 0.05).The difference was statistically significant.3.Multivariate analysis showed that: High MMP-9 levels(OR = 6.451,P < 0.05,95% CI1.854-22.452),aging(OR=2.107,P < 0.05,95% CI1.263-3.513)are independent risk factors of CI after ischemic stroke.High TIMP-1 levels(OR = 0.057,P<0.05,95% CI 0.013-0.255),smoking(OR=0.098,P<0.05,95% CI 0.014-0.665)are protective factors of CI after ischemic stroke.4.In the CI group,the correlation analysis showed that:The serum MMP-9 levels were negatively correlated and serum TIMP-1 levels were positively correlated with the Mo CA scores.5.The accuracy rate of predicting CI after ischemic stroke was 65.5% and 71.4% respectively,with the serum MMP-9 concentration?437.895?g / L and TIMP-1?41.390?g / L.Conclusion:1.The levels of serum MMP-9 and TIMP-1 in the acute stage of ischemic stroke were significantly increased.2.In the acute stage of ischemic stroke,high serum MMP-9 levels and aging are the risk factors,while low TIMP-1 levels and smoking are the protective factors of CI after ischemic stroke.3.The serum MMP-9 levels were negatively correlated and serum TIMP-1 levels were positively correlated with the Mo CA scores in the CI group.4.Measurement the serum levels of MMP-9 and TIMP-1 in the acute stage of ischemic stroke,when combined with a systematic screening for other predictors of CI after ischemic stroke,may help identify patients at greater risk of developing CI after ischemic stroke.