关键词: 脑出血; 血肿; 基质金属蛋白酶9; 细胞纤维连接蛋白; 纤维蛋白原

Abstract:

Objective To study dynamic change of hematoma volume, and the correlation between molecularbiological markers of peripheral blood and early hematoma growth in the patients with intracerebralhemorrhage, we aimed to identify the predictive factors of early hematoma growth, we also hope toexplore the possible pathophysiologic mechanism of early hematoma growth.Methods It was an open, prospective, single-centered cohort study. 67 spontaneous cerebralhemorrhagic patients within 6 hours after onset were collected consecutively from Apr. 2007 toDec. 2007, 54 patients were enrolled in the study based on inclusion and exclusion criteria. Clinicaldata and blood samples were collected. Cellular fibronectin, matrix metalloproteinase-9, tissueinhibitor of metalloproteinases-1 of spontaneous cerebral hemorrhagic 54 patients were measuredwith commercially available quantitative sandwich enzyme-linked immunosorbent assay kits,laboratory regular measures such as fibrinogen were collected. Patients were divide into two groupsby hematoma growth criterion, Potential predictors of early hematoma growth were analyzed byunivariate analysis or logistic regression.Results Among all recruited patients who were given CT scan at 24 hours after the onset ofICH, 16 cases appeared hematoma growth, thus the incidence of hematoma growth was 29.63%.Independent-Samples T Test revealed that the fibrinogen level was remarkably lower in hematomagrowth patients than that of non-hematoma growth patients(2.3±0.7 vs 2.9±0.7g/L, P =0.008), and χ2test revealed that the incidence of hematoma growth in patients with irregular-shaped hematoma oninitial CT scan was higher than that of patients with a round hematoma(50.0% vs 13.2%, P =0.011).Multivariate analysis of predictors of hematoma growth revealed that there were two independentrisk factors of hematoma growth, while c-Fn was not, MMP-9(OR=12.093, P =0.032) & fibrinogenlevel(OR=0.162, P =0.041) which may predict the growth of hematoma volume.Conclusion MMP-9 and fibrinogen level were two independent risk factors of hematoma growth,but cellular fibronectin and tissue inhibitor of metalloproteinases-1 were not related to hematomagrowth.

Key words: Cerebral hemorrhage; Hematoma; Matrix metalloproteinase 9; Connexins; Fibrinogen