基因组学与应用生物学

观察糖皮质激素治疗脑出血后脑水中患者过程中血清MDA、MMP-9和ICAM-1水平的变化,探讨这种变化与糖皮质激素治疗脑出血后脑水肿的疗效关系。2010年1月至2015年12月入院的脑出血患者100例,按随机数字表法分为两组,分为常规治疗组50例和GC组50例。健康体检对照组50例。检测脑出血患者不同时间血清中的MDA、MMP-9和ICAM-1水平,通过CT检查计算同时间的脑水肿体积。TBA法检测MDA含量,酶联免疫吸附试验检测血清MMP-9和ICAM-1水平。入院24 h内,常规治疗组和GC组血清MDA含量,MMP-9和ICAM-1水平均高于健康对照组(p<0.05)。24 h内常规治疗组与GC组比较,脑水肿体积、MDA、MMP-9和ICAM-1差异均无统计学意义。而治疗后7 d和14 d,GC组与常规治疗组比较,脑水种体积、MDA、MMP-9和ICAM-1均减少(p<0.05),GC组MMP-9和ICAM-1与脑水肿体积呈正相关(r=0.881,r=0.845,r=0.861,p<0.05)。治疗后14 d,GC组MDA与脑水肿体积无相关性。糖皮质激素可能通过降低ICMA-1和MMP-9表达,消除自由基等机制减少脑出血后脑水肿程度。

The aim of this experiment is to observe glucocorticoid regulation on malondicadelyde,intercellular adhesion molecule-1 and matrix metalloporteinase-9 serum levels of patients with brain edema after cerebral hemorrhage and to explore the mechanism of glucocorticoid therapy for brain edema after cerebral hemorrhage.100 cases of patients with the cerebral hemorrhage were divided into two groups according to random number table method in our hospital from January 2014 to December 2015.50 cases of patients used routine treatment and50 cases of used glucocorticoid therapy.50 cases of healthy examination served as control group.The serum levels of malondicadelyde,intercellular adhesion molecule-1 and matrix metalloporteinase-9 were detected in patients with cerebral hemorrhage at different time,brain edema volume were calculated through the CT examination at the same time.The serum levels of malondicadelyde were detected by TBA methods,while the serum levels of intercellular adhesion molecule-1 and matrix metalloporteinase-9 were detected by enzyme-linked immunosorbent assay.The serum levels of malondicadelyde,intercellular adhesion molecule-1 and matrix metalloporteinase-9in patients with conventional treatment group and GC group were both higher than the serum levels of that in patients with healthy control groups within 24 hours(p<0.05).Compared with GC group,cerebral edema volume,malondicadelyde,intercellular adhesion molecule-1 and matrix metalloporteinase-9 of conventional treatment group have no statistically significant difference with 24 hours(p>0.05).Compared with conventional treatment group,cerebral edema volume,malondicadelyde,intercellular adhesion molecule-1 and matrix metalloporteinase-9 of GC group were reduced after treatment of 7 days and 14 days(p<0.05).The serum levels of intercellular adhesion molecule-1 and matrix metalloporteinase-9 were positively correlated with cerebral edema volume after treatment of 7 days and 14 days(r=0.881,r=0.845,r=0.861,p<0.05).MDA and cerebral edema volume of the GC group has no relevance after treatment of 14 days.By lowering the expression of ICAM-1 and MMP-9,eliminating free radical mechanism,glucocorticoid may reduce cerebral edema after cerebral hemorrhage.