| Objective:This study mainly investigate the relationship between serum MMP-9 expression and Cerebral Vasospasm(CVS)in patients with Aneurysmal Subarachnoid Hemorrhage(a SAH),and the effect of traditional Chinese medicine therapy "Qufeng Huoxue Tongluo" combined with nimodipine on serum MMP-9,and to evaluate the efficacy of traditional Chinese medicine therapy "Qufeng Huoxue Tongluo " in the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage.Methods:Forty-eight a SAH patients with Hunt-Hess grade Ⅰ-Ⅳ were selected from Department of Neurosurgery,affiliated Hospital of traditional Chinese Medicine,Southwest Medical University from June 2018 to June 2019.The patients were randomly divided into control group(n = 24)and treatment group(n = 24).The control group was treated with nimodipine on the basis of symptomatic treatment.The treatment group was treated with symptomatic treatment,nimodipine and the traditional Chinese medicine therapy “Qufeng Huoxue Tongluo”.Gelatin zymography was used to detect the content of MMP-9 in serum of the two groups on the 2nd,4th,6th,8th,10th,12th and 14th day after onset,and the mean blood flow velocity of ipsilateral middle cerebral artery was measured by transcranial Doppler ultrasound(TCD).24 healthy volunteers who underwent physical examination in our hospital in the same period were selected as the healthy group,and the serum MMP-9 content of the healthy people was compared with the control group and the treatment group.Results:1.There was no significant difference in the content of serum MMP-9 between healthy subjects(P=0.653);The content of serum MMP-9 in patients with aneurysmal subarachnoid hemorrhage was significantly higher than that in healthy subjects(P< 0.05).2.CVS in patients with a SAH worsened significantly from 4 to 6 days after onset,reached the peak at 8 to 10 days,and basically returned to normal at about 14 days,while the content of serum MMP-9 increased significantly from 2 to 4days after onset,peaked at 6 to 8 days,then began to decrease slowly,and was still higher than that in healthy people at 14 days,which was consistent with CVS(P< 0.01).The expression of serum MMP-9 was positively correlated with the degree of CVS(P < 0.05).3.The content of serum MMP-9 and the degree of cerebral vasospasm in the treatment group were lower than those in the control group at 4 to 6 days and 8 to 10 days(P < 0.05).4.There were 3 cases of cerebral infarction in the control group,and the incidence of cerebral infarction was 12.5%;There were 2 cases of cerebral infarction in the treatment group,and the incidence of cerebral infarction was 8.4%.There was no significant difference in the incidence of cerebral infarction between the two groups(P > 0.05).Conclusion:1.The content of serum MMP-9 is positively correlated with the degree of CVS.It is speculated that MMP-9 is involved in the pathological process of the occurrence and development of CVS.2.Monitoring the content of serum MMP-9 can predict the degree of cerebral vasospasm.3.Traditional medicine "Qufeng Huoxue Tongluo" combined with nimodipine treatment can significantly reduce the content of serum MMP-9 and relieve the degree of cerebral vasospasm compared with nimodipine alone.It is speculated that "Qufeng Huoxue Tongluo" may relieve cerebral vasospasm by inhibiting serum MMP-9 activity.4.There was no significant difference in the incidence of cerebral infarction between the treatment group and the control group(P >0.05). |
