实验性脑血管痉挛兔基质金属蛋白酶-9的变化研究_临床医学论文.docVIP

实验性脑血管痉挛兔基质金属蛋白酶-9的变化研究_临床医学论文 实验性脑血管痉挛兔基质金属蛋白酶-9的变化研究_临床医学论文 【摘要】 观察实验性新西兰白兔蛛网膜下腔出血（SAH）后脑血管痉挛血清基质金属蛋白酶-9（MMP-9）及血浆血管内皮生长因子（VEGF）浓度的动态变化，探讨它们与脑血管痉挛的发生、发展及转归过程的关系，从而为临床诊断及治疗提供理论依据。方法 新西兰白兔60只，随机分为假手术组（n=30）及模型组（n=30）。采用枕大池二次注血法进行蛛网膜下腔脑血管痉挛模型的制作。分别将两组实验动物于第1、3、5、7、9、14天采取兔空腹血，应用酶联免疫、双抗体夹心法化验血清中的MMP-9及血浆VEGF的浓度，同时进行经颅多普勒（TCD）检测基底动脉最大流速判定脑血管痉挛。结果 假手术组血清MMP-9的浓度及血浆VEGF的浓度无明显变化，在模型组中血清MMP-9及血浆VEGF浓度于注血后24ｈ开始升高，至5～7天达高峰，以后逐渐减退，14天时接近正常。结论 血清MMP-9及VEGF的浓度变化可以预测蛛网膜下腔出血后脑血管痉挛的发作，判断其发展及预后，从而为临床治疗提供依据。 【关键词】 基质金属蛋白酶-9 血管内皮生长因子 脑血管痉挛 经颅多普勒 Study of serum matrix metalloproteinase-9 in rabbit with cerebral vasospasm after subarachnoid hemorrhage ［Abstract］ Objective To observe the change of the level of serum matrix Metalloproteinase-9 （MMP-9）and plasm vascular endothelial growth factor（VEGF） in experimental after cerebral vasospasm（CVS） with subarachnoid hemorrhage（SAH） in New Zealand rabbit model，and discuss the relation of the change about serum MMP-9 and VEGF after SAH，then provide the basic theory for clinical diagnosis and treatment.Methods 60 adult New Zealand rabbits were randomly divided into two groups: control group and model group.The rabbit SAH model was constructed by blood injection into cisterna magnum twice.Both the two groups were venipunctured at the 1st,3rd,5th,7th,9th and 14th day.All the rabbits were fasted before the blood were drawn.Serum MMP-9 and plasm VEGF were detected by the enzyme-linked immunospecific assay.And basilar artery blood fluid speed was examined by transcranial Doppler（TCD） at the same time.Results There was little change of serum MMP-9 and plasm VEGF in the control group.But in the model group，the level of them increased progressively at the 24th hour after operation，the peak was at the 5th～7th day，and decreased to the normal state at 14th day.Conclusion The change of the level of MMP-9 and VEGF could be used to predict the onset，progress and the prognosis of CVS after SAH，and provide the basic theory for the clinical diagnoses and tr