目的 探討急性進(jìn)展性腦梗死（PCI）患者外周血基質(zhì)金屬蛋白酶-9（MMP-9）、S100蛋白（S100B）、髓鞘堿性蛋白（MBP）水平的變化及其與PCI的相關(guān)性；探討注射用丹參多酚酸對(duì)上述血清因子的調(diào)節(jié)作用。方法 選擇發(fā)病時(shí)間在24 h內(nèi)的急性腦梗死住院患者90例，PCI 60例，非進(jìn)展性腦梗死（NPCI）30例，借助SAS統(tǒng)計(jì)分析軟件隨機(jī)將PCI分為2組，每組30人，對(duì)照組給于基礎(chǔ)藥物（阿司匹林腸溶片100 mg，口服，每日1次；阿托伐他汀鈣片20 mg，口服，每晚1次；依達(dá)拉奉注射液30 mg，靜脈點(diǎn)滴，每日2次）；觀察組給于基礎(chǔ)藥物治療加注射用丹參多酚酸0.13 mg用0.9%氯化鈉注射液250 mL溶解后使用，靜脈滴注，每日1次；療程均為14 d。比較PCI組與NPCI組在治療前血清MMP-9、S100B、MBP水平；比較觀察組與對(duì)照組在治療前及治療14 d后血清MMP-9、S100B、MBP的水平以及美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分。結(jié)果 治療前，PCI組血清MMP-9、S100B、MBP的水平顯著高于NPCI組（P<0.05）；治療后觀察組與對(duì)照組血清MMP-9、S100B、MBP水平均明顯下降，與治療前比較差異均具有統(tǒng)計(jì)學(xué)意義（P<0.05），且觀察組較對(duì)照組3者水平明顯降低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療14 d后，與治療前比較，觀察組NIHSS評(píng)分明顯下降，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），對(duì)照組變化不顯著；且治療后觀察組較對(duì)照組NIHSS評(píng)分明顯下降，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 腦梗死的進(jìn)展與血清MMP-9、S100B、MBP的水平變化有關(guān)；注射用丹參多酚酸可調(diào)節(jié)血清MMP-9、S100B、MBP的水平達(dá)到防止腦梗死進(jìn)展的作用。

Objective To investigate the changes of MMP-9, S100B and MBP level in peripheral blood of patients with acute progressive cerebral infarction (PCI) and its correlation with acute progressive cerebral infarction. To investigate the regulatory effect of Salvianolic Acids for Injection on these serum factors. Methods Selection of 90 inpatients with acute cerebral infarction within 24 hours after onset, 60 cases of PCI, 30 cases of non-progressive cerebral infarction (NPCI), PCI was randomly divided into two groups with 30 people in each group by means of SAS statistical analysis software. The patients in control group were given basic drugs (aspirin enteric-coated tablets 100 mg, orally, once a day; atorvastatin calcium tablets 20 mg, orally, once a night; edaravone injection 30 mg, intravenous drip, twice a day). The patients in observation group were given basic drugs plus Salvianolic Acids for Injection 0.13 mg for injection and 0.9% sodium chloride injection 250 mL for dissolution, intravenous drip once a day; the treatment course was both 14 d. The levels of serum MMP-9, S100B and MBP were compared between the PCI group and the NPCI group before treatment. The serum MMP-9, S100B and MBP levels were compared between observation and control group before and 14 days after treatment. The score of somatic nerve function defect (NIHSS) were compared between observation and the control group before and 14 days after treatment. Results The serum MMP-9, S100B and MBP level in PCI group was higher than that in NPCI group (P<0.05). After treatment, the levels of serum MMP-9, S100B and MBP in observation and control group were significantly decreased, with statistical significance compared with those before treatment (P<0.05), and the levels in the observation group were significantly lower than those in control group (P<0.05). After 14 days of treatment, the NIHSS scores in observation group were significantly decreased compared with those before treatment (P<0.05). There was no significant change in the control group, and the NIHSS score of observation group was significantly lower than that of control group after treatment (P<0.05). Conclusion The progression of cerebral infarction is related to the level of serum MMP-9, S100B and MBP and Salvianolic Acids for Injection can regulate the level of serum MMP-9, S100B and MBP to prevent the progression of cerebral infarction.

吳階平醫(yī)學(xué)基金會(huì)臨床科研項(xiàng)目（320.6750.16133）