The Dynamic Changes Of Thrombin And MMP-9 In Plasm And The Relevance Between Them After Intracerebral Hemorrhage

Intracerebral hemorrhage(ICH) is a common disease in the nervous system, characterized by high incidence mortality and unability,which is a serious threat to human life and health,up to now is still a fundamental lack of treatment. After the occurrence of intracerebral hemorrhage,the mechanism of hematoma surrounding tissue of the secondary injury are multi-faceted,including brain edema around the hematoma which is focused on being to prove the important causes in ICH now.A large number of animal experiments at home and abroad after intracerebral hemorrhage have confirmed that thrombin involved in the occurrence of brain edema and the development process,while the activation of thrombin in the edema period making increases of the expression of MMP-9, which is to be proved another key pathogenic factors in the edema period.The two factors promote each other,increase the occurrence and development of the process of the brain edema after intracerebral hemorrhage. Objectives:This study is to concern about the blood levels of the thrombin and MMP-9 in the acute phase of cerebral hemorrhage at different time points which using ELISA method measured the clinical patients with intracerebral hemorrhage;To investigate the levels of thrombin,MMP-9 of patients in the acute phase of intracerebral hemorrhage and by the dynamic changes when the correlation between the two factors;To lay a clinical theoretical basis for the acute phase intracerebral hemorrhage.Methods:To test the thrombin and MMP-9 levels of blood samples in 45 cases of patients which have been diagnosised with supratentorial intracerebral hemorrhage at different time points after onset(within 24 hours,5d,10d,15d). At the same time,to detect the contents of the thrombin and MMP-9 of the 15 cases of normal subjects.To compare with inter groups by T-test,to determine whether there is correlation between the two factors by correlation analysis.Results:By the detection of ELISA in our clinical experiment,there is low expression of thrombin and MMP-9 in healthy people,15 cases of healthy human thrombin concentration is(54.09±26.81) U/L,MMP-9 level is(63.15±34.70) ng/ml.The concentration of the thrombin significantly increased at 24 hours,along with the course of intracerebral hemorrhage,the level increased higher,it got the peak at 5 days,it declined gradually at 10 days and at 15 days it decreased significantly.But the level couldn't get normal in acute phase to compare with the healthy group.The concentration of MMP-9 in the incidence began to increase at 24 hours,reached a peak about 5 days,10 days decreased, 15 days a further decline in more than 24 hours decreased significantly in the incidence,only slightly higher than normal group.Patients with intracerebral hemorrhage within 24 hours after onset,5 days,10 days,15 days on average for thrombin is(170.55±31.54) U/L,(218.36±41.99) U/L,(193.95±39.27) U/L, (155.05±27.38) U/L,the average level of the thrombin in the whole process is (184.48±42.65) U/L;And the concentration of MMP-9 by the time changes are dynamic:(255.49±53.78) ng/ml,(415.81±78.80) ng/ml,(312.70±56.28),(134.11±37.57) ng/ml,and the average concentration of MMP-9 in the process is (279.53±117.35) ng/ml.Through the correlation analysis,the thrombin level in patients with intracerebral hemorrhage and MMP-9 content in plasma of the dynamic changes,the two peaks(the first 5 days) was positively correlated(r= 0.850,P＜0.01),both by the dynamic changes when the whole process still has highly correlated(r=0.837,P＜0.01).Conclusions:1.There exist low expression of thrombin and MMP-9 in plasm of healthy people.2.The concentration of the thrombin significantly increased at 24 hours, along with the course of intracerebral hemorrhage,the level increased higher,it got the peak at 5 days,it declined gradually at 10 days and at 15 days it decreased significantly.But the level couldn't get normal in acute phase to compare with the healthy group.3.The level of MMP-9 in the incidence began to increase at 24 hours, reached a peak at 5 days,then to decline,10 days decreased,15 days a further decline in more than 24 hours,decreased significantly in the incidence,only slightly higher than normal group.4.By correlation analysis,the abnormal expression in the ultra-early,the peak period are synchronized between the thrombin and MMP-9.It is to be thought that the expression is mutually reinforcing between the thrombin and MMP-9.In the whole process of the acute phase,the higher concentration of the thrombin,the higher level of the MMP-9.Thrombin levels and MMP-9 levels were positively related to each other.In the late period of the incidence,the rate which decreased of the thrombin level is slow compared with the MMP-9.At 15 day in the incidence of reduction in the level of MMP-9 leveled closer to normal, or slightly exceeded than normal levels.