摘要
目的探讨大剂量乌司他丁对高血压相关早期重型脑桥出血患者穿透素-3(PTX-3)、基质金属蛋白酶-9(MMP-9)和血清S100B蛋白水平的影响。方法选取2013年1月至2014年12月在山西省平顺县人民医院心血管内科,以及长治市人民医院重症医学科和神经内科就诊,具有高血压合并脑桥出血患者30例,采用前瞻性对照研究方法将30例患者,分为2组,常规高血压合并脑桥出血组(15例)接受常规药物治疗、乌司他丁组(15例)在常规药物治疗基础上加以大剂量乌司他丁80万U入液静脉滴注,每日1次。另设20例高血压合并基底节出血患者作为对照(常规对照组)。常规检查:血压、血脂、体质量指数(BMI)、血糖及胰岛素抵抗指数(HOMA-IR)等。3组治疗前后分别检测血浆PTX-3、血清S100B蛋白和MMP-9变化。结果乌司他丁组及常规高血压合并脑桥出血组血浆PTX-3及MMP-9较常规对照组明显增加[PTX-3为(25.5±4.3)、(25.1±3.9)、(12.8±3.2)ng/ml,F=1.98,P<0.05;MMP-9为(108±11)、(110±14)、(94±17)ng/L,F=2.41,P<0.05]。乌司他丁组治疗1周后分别与常规高血压合并脑桥出血组及常规对照组比较,血浆PTX-3、血清S100B蛋白及MMP-9均显著减低。而且改善脑桥出血预后明显优于常规高血压合并脑桥出血组(χ2=11.2,P<0.01)。血浆PTX-3与BMI、HOMA-IR及血肿体积呈正相关(r=0.41,0.39,0.34;P<0.05),血清S100B蛋白与MMP-9呈正相关(r=0.40,P<0.01)。结论静脉滴注大剂量乌司他丁可改善高血压相关早期重型脑桥出血患者预后,显著降低血清S100B蛋白、MMP-9及PTX-3水平。
Objective To investigate the effects of large-dose ulinastatin on the levels of plasma pentraxin-3 （PTX-3）, matrix metalloproteinase-9 （MMP-9） and serum S100B protein in patients with hypertension-related early se-vere pons hemorrhage. Methods Thirty patients （26 males and 4 females; mean age： 47 years old） with hypertension and pons hemorrhage, who were hospitalized in the Department of Cardology, People′s Hospital of Pingshun County in Shanxi Province and the ICU and Department of Neurology, Changzhi Municipal People′s Hospital Affiliated to Shanxi Medical University between January 2013 and December 2014, were included as the subjects in the study. A prospective controlled study was used, and all 30 patients were divided into two groups. The regular hypertension and pons hemorrhage group （n=15） received the conventional drug therapy, and the Ulinastatin group （n=15） received in-travenous drip infusion of high-dose ulinastatin 800 000 U） based on the conventional drug therapy, once daily. Meanwhile, another 20 patients with hypertension and basal ganglia hemorrhage were included as the conventional control group. All patients underwent the routine examination, including blood pressure, blood lipid, body mass index （BMI）, blood glucose, and homeostasis model assessment of insulin resistance （HOMA-IR）. The changes of plasma PTX-3, serum S100B protein and MMP-9 in the three groups were determined before and after the treatment, respec-tively. Results The levels of plasma PXT-3 and MMP-9 in the ulinastatin group and regular hypertension and pons hemorrhage group were significantly increased compared with those in the control group [plasma PTX-3： （25.5 ±4.3）, （25.1±3.9）, （12.8±3.2） ng/ml, F=1.98, P〈0.05;MMP-9：（108±11）, （110±14）, （94±17） ng/L, F=2.41, P〈0.05.]. Compared with the regular hypertension and pons hemorrhage group and conventional control group after one-week treatment, the levels of plasma PXT-3, serum S100B protein and MMP-9 were significantly decreased in the ulinastatin group. The prognosis of improved pons hemorrhage in the ulinastatin group was significantly better than that in the hypertension and pons hemorrhage group （χ2=11.2, P〈0.01）. The plasma PTX-3 was positively correlated with the BMI, HOMA-IR and hematoma volume （r=0.41, 0.39, and 0.34, P〈0.05）, whereas serum S100B protein was positively correlated with MMP-9 （r=0.40, P〈0.01）. Conclusion Intravenous drip infusion of high-doses ulinastatin can improve the prognosis of patients with hypertension-related early severe pons hemorrhage, and significantly decrease the levels of serum S100B protein, MMP-9 and plasma PTX-3.
出处
《中国药物与临床》
CAS
2015年第9期1244-1248,共5页
Chinese Remedies & Clinics
基金
山西省长治市科技星火资助项目(200704009)
山西省长治市基础研究资助项目(201405010)
作者简介
通信作者：王国平，E-mail：guopingwang60a@163．com
