Abstract：【Objective】To explore the relationship between glial fibrillary acidic protein (GFAP), matrix metalloproteinase-9 (MMP-9) and the degree of neurological damage in patients with hypertensive intracerebral hemorrhage (HICH).【Methods】A total of 102 HICH patients and 85 hypertensive patients without cerebral hemorrhage were recorded as HICH group and hypertensive group, respectively. Another 80 healthy individuals who underwent physical examination were selected as the health group. Three groups of GFAP and MMP-9 levels were compared; The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the degree of neurological damage in HICH patients, and based on this, they were divided into mild, moderate, and severe groups. We compared the levels of GFAP and MMP-9 in HICH patients with different degrees of neurological deficits. Pearson correlation analysis was used to investigate the correlation between GFAP, MMP-9 levels and the degree of neurological damage in HICH patients. After a 6-month follow-up, the prognosis of HICH patients was evaluated based on the Glasgow Outcome Scale (GOS), and the levels of GFAP and MMP-9 were compared between the group with good prognosis and the group with poor prognosis. A receiver operating characteristic curve (ROC) was created to analyze the predictive value of GFAP, MMP-9, and their combination on the prognosis of HICH patients using area under the curve (AUC).【Results】The levels of GFAP and MMP-9 in patients with hypertension and HICH were higher than those in the healthy group (P<0.05); The levels of GFAP and MMP-9 in the HICH group were higher than those in the hypertension group (P<0.05). The levels of GFAP and MMP-9 in patients in the moderate and severe groups were higher than those in the mild group (P<0.05); The levels of GFAP and MMP-9 in the severe group were higher than those in the moderate group (P<0.05). The levels of GFAP and MMP-9 in HICH patients are positively correlated with the degree of neurological damage (P<0.05). The levels of GFAP and MMP-9 in the poor prognosis group were higher than those in the good prognosis group (P<0.05). The ROC results showed that the AUC of GFAP, MMP-9, and their combination for predicting the prognosis of HICH patients were 0.978, 0.884, and 0.925, respectively. GFAP had the highest predictive value for the prognosis of HICH patients. 【Conclusion】Serum levels of GFAP and MMP-9 are related to the degree of neurological damage and prognosis in HICH patients, and have a high predictive power for patient prognosis.
黄利娜, 李相磊, 张海军. 血清GFAP、MMP-9检测对高血压脑出血患者神经功能损伤程度的预测价值[J]. 医学临床研究, 2024, 41(2): 210-213.
HUANG Lina, LI Xianglei, ZHANG Haijun. The Predictive Value of Serum GFAP and MMP-9 Detection for Neurological Damage in Patients with Hypertensive Intracerebral Hemorrhage. JOURNAL OF CLINICAL RESEARCH, 2024, 41(2): 210-213.
[1] HAWKES M A, RABINSTEIN A A. Acute hypertensive response in patients with acute intracerebral hemorrhage: a narrative review[J].Neurology,2021, 97(7):316-329.
[2] SHEN J, GUO F, YANG P, et al. Influence of hypertension classification on hypertensive intracerebral hemorrhage location[J].J Clin Hypertens (Greenwich),2021, 23(11):1992-1999.
[3] 卜君辉, 梁赛, 吴继伟, 等. 血清TIMP-1、TIM-3mRNA及CTRP-3水平与高血压脑出血手术患者神经功能损伤程度及预后相关性研究[J].立体定向和功能性神经外科杂志, 2021, 34(3):170-175.
[4] CAO D, LIU F, LIU Q, et al. Correlation analysis between TSP2, MMP-9 and perihematoma edema, as well as the short-term prognosis of patients with hypertensive intracerebral hemorrhage[J].Ann Palliat Med,2021, 10(10):10930-10937.
[5] 中华医学会神经外科学分会, 中国医师协会急诊医师分会, 中华医学会神经病学分会脑血管病学组,等. 高血压性脑出血中国多学科诊治指南[J].中国急救医学, 2020, 40(8):689-702.
[6] 中国高血压防治指南修订委员会. 中国高血压防治指南2018年修订版[J].心脑血管病防治, 2019, 19(1):1-44.
[7] RUNDE D. Calculated decisions: national institutes of health stroke scale (NIHSS)[J].Emerg Med Pract,2019, 21(6):41-43.
[8] RUBIN M L, YAMAL J M, CHAN W, et al. Prognosis of six-month glasgow outcome scale in severe traumatic brain injury using hospital admission characteristics, injury severity characteristics, and physiological monitoring during the first day post-injury[J].J Neurotrauma,2019, 36(16):2417-2422.
[9] QIAN T D, ZHENG X F, SHI J, et al. L4-to-L4 nerve root transfer for hindlimb hemiplegia after hypertensive intracerebral hemorrhage[J].Neural Regen Res,2022, 17(6):1278-1285.
[10] GYLDENHOLM T, HVAS C L, HVAS A M, et al. Serum glial fibrillary acidic protein (GFAP) predicts outcome after intracerebral and subarachnoid hemorrhage[J].Neurol Sci,2022, 43(10):6011-6019.
[11] 程伟, 包艳娥, 李婉秋, 等.MMP-9/TIMP-1比值与高血压脑出血病情的相关性研究[J].神经损伤与功能重建, 2021, 16(9):526-528.
[12] KOCE M, JERIN A, PLUT D, et al. No increase in GFAP and S-100B in very preterm infants with mild periventricular leukomalacia or intraventricular hemorrhage: a pilot study[J].Croat Med J,2022, 63(6):564-569.
2024, Vol. 41 
