Effect On Matrix Metalloproteinase-9 Of Intracerebral Hemorrhage Patients Using Mannitol And Glycerin Fructose

Object: Brain edema is one of the most important reasons that result in aggravation and hemiplegia of intracerebral hemorrhage patients. A induced mechanism is blood-brain barrier (BBB) disruption,study shows that overexpression of matrix metalloproteinase (MMPs) such as MMP-9 participate in BBB damage and aggravate brain edema. Therefore, if we can prevent the increase of MMP-9 early, maybe can weaken the bad prognosis of brain edema. The most popular medicine for edema treatment and prevention is dehydrating agents, such as mannitol and Glycerin Fructose. The study is to discuss the difference of effect on MMP-9 level and moter funtion of ICH patients between mannitol and glycerin fructose.Method:the chosen subjects are sixty ICH inpatients in Neurology Department of 1st clinical hospital of JiLin University,who were randomized in mannitol group or glycerin fructose group,then we determined the MMP-9 level of venous blood after 24 hours,five days,ten days and fifteen days respectively, what's more, we assess the motor funtion on corresponding time point and three month, six month after ICH using fugl-meyer assessment scale.Result:MMP-9 level of mannitol group and glycerin fructose group after 24 hour onset both decreased,but mannitol group reduced more obviously,there is apparent difference between the two groups (P<0.05=. MMP-9 level of the two groups change parallel with the course of ICH positively, reach the peak between four to seven days, it is higher in 5th day than on 24 hour, 10th and 15th day,and mannitol group still deceased more apparently, there is significant difference between 5th and 10th day (P<0.01); MMP-9 level of the two groups after fifteen days deceased obviously, but still higher than after 24 hour, mannitol group lowered significantly than glycerin fructose group (P<0.01). Motor funtions of the two groups at corresponding time point and after three month and six month improved gradually, there was no difference between the two groups in statistics.Conclusion:MMP-9 level decreases after using mannitol and glycerin fructose,and mannitol plays a more powerful role.The two medicine have no significant difference on motor funtion of patients with cerebral hemisphere hemorrhage (within 20-30ml), not involving ventricle and wake consciousness.