Correlation Between Serum Matrix Metalloproteinase-9 And The Severity And Outcome Of Aneurysmal Subarachnoid Hemorrhage

Objective:To study and analyze the relationship between the content of Matrix metalloproteinase-9(mmp-9)in the early serum of patients with intracranial aneurysmal subarachnoid hemorrhage and the severity of the disease and the outcome of surgical treatment.Methods:Prospective for ruptured intracranial aneurysm caused by SAH patients,collect demographic data,past medical history,WFNS score,Fisher stage,postoperative complications,such as material,using Fisher bleeding degree classification,grade 1~2 is a severe,grade 3~4 as severe,symptoms degree WFNS score,1~3 is a severe,4~5 for severely,using Glasgow Outcome Scale(Glasgow Outcome Scale,GOS),Outcome evaluation,divided into poor Outcome 1~3,4~5 divided into Outcome is good,Combined with the content of mmp-9 in the serum of the patients within 24 hours after admission,univariate analysis and multivariate logistic regression analysis were used to determine whether the content of mmp-9 in the serum was a factor affecting the severity of the disease and the outcome of surgical treatment.Results:A total of 97 patients with aSAH were included,including 53 patients with good outcome(54.64%),44 patients with poor outcome(45.36%),and 0 patients with death.There were 49 cases(50.52%)with grade 1 to 2,48 cases(49.48%)with grade 3 to 4,47 cases(48.45%)with grade 1 to 3,and 50 cases(51.55%)with grade 4 to 5 in WFNS.Univariate analysis showed that the composition ratio of patients with higher mmp-9 concentration,higher WFNS grade,ventricular hematocele or ventricular cast in the severe hemorrhage group was significantly higher than that in the non-severe hemorrhage group.Results of multivariate Logistic regression analysis showed that: Higher mmp-9 concentration(OR=0.327,95%CI 3.646~9.826,P=0.013),higher WFNS grade(OR=2.462,95%CI 7.362~11.359,P=0.008),ventricular hematocele OR ventricular cast(OR=3.617,95%CI 6.269~6.472,P=0.037)were independent risk factors for severe hemorrhage.Univariate analysis showed that the proportion of patients with higher mmp-9 concentration,higher Fisher grade,and ventricular hematocele or ventricular cast in the severe symptoms group was significantly higher than that in the non-severe symptoms group.The results of multivariate Logistic regression analysis showed that: Higher mmp-9 concentration(OR=0.853,95%CI 1.432-3.315,P=0.015),higher Fisher grade(OR=1.372,95%CI 3.784-8.574,P=0.003),ventricular hematocele OR ventricular cast(OR=1.346,95%CI 2.534-6.546,P=0.027)are independent risk factors for severe symptoms.In the adverse outcome group,the proportion of patients with higher mmp-9 concentration,higher Fisher grade,higher WFNS grade,postoperative cerebral infarction,postoperative intracranial infection,>24 hours from onset to treatment,and preoperative re-bleeding was significantly higher than that in the favorable outcome group.The results of multivariate Logistic regression analysis showed that: Mmp-9 concentration was higher(OR=3.864,95%CI 2.388~6.926,P=0.014),Fisher grade was higher(OR=3.141,95%CI 8.529~18.647,P=0.028),WFNS grade was higher(OR=1.139,95%CI 1.026~3.045,P=0.031),postoperative cerebral infarction(OR=8.456,95%CI 7.057~19.447).P<0.001)and preoperative rehemorrhage(OR=5.022,95%CI 6.922~27.357,P<0.001)were independent risk factors for poor postoperative outcomes.Conclusion:High serum mmp-9 concentration is an independent risk factor for severe bation is expected to be an indicator for evaluating postoperative outcomes of aneurysleeding and poor postoperative outcomes,and detection of serum mmp-9 concentrmal subarachnoid hemorrhage.The more obvious the symptoms were after hemorrhage.Control of postoperative cerebral infarction can improve postoperative outcome of patients,but patients with higher Fisher grade and WFNS grade and preoperative rebleeding generally have poor postoperative outcome.