Abstract: Objective To explore the change characteristics of the cerebrospinal fluids matrix metalloproteinase-9 (MMP-9) in different severity levels of hypoxic-ischemic encephalopathy (HIE). Method Totally 60 HIE child patients were selected as the subjects and they were divided into three groups:the mild group,the moderate group and the severe group in terms of the severity,20 patients in each group.The 1^st,7^th,14^th and 21^st day were the time points after the seizure,the ELISA method was employed to detect the levels of MMP-9.Electroencephalography (aEEG) was also monitored with an observing table to record the clinical data. Results The detected levels of MMP-9 were different in different time points for the HIE with the same severity.The different levels of MMP-9 in different time points in the HIE mild group showed no statistic significance (P>0.05).The HIE moderate group and the HIE severe group showed statistic significances (P<0.05).The detected levels of MMP-9 were also different at the same time point for the HIE with the different severity.The 1^st day MMP-9 levels showed statistic significance (P＜0.05) among the three groups.The 7^th day showed statistic significance between the mild and moderate group,between the moderate and severe group (P＜0.05).The 14^th and 21^st day showed statistic significance between the mild and severe group (P＜0.05).The 21^st day showed statistic significance between the MMP-9 with different prognoses (P＜0.05),and there was a weak correlation between MMP-9 levels and the HIE prognosis (P=0.007).On the 1^st,14^th and 21^st day,the MMP-9 levels changed in certain correlation with the 60 cases (P<0.05). Conclusions The levels of the cerebrospinal fluids MMP-9 are in correlation with the severity of HIE and can be used as an indicator for the early treatment and prognosis of HIE.

Key words: full-term newborns, hypoxic-ischemic encephalopathy, matrix metalloproteinase-9

摘要： 目的 探讨脑脊液基质金属蛋白酶-9(MMP-9)在不同程度缺氧缺血性脑病(HIE)及其病程中的变化特征。方法 选择HIE患儿60例作为研究对象,根据HIE严重性将其分为轻度、中度和重度HIE组,每组20例。HIE发病后第1、7、14天及第21天为研究时相点,在各时相点采用ELISA夹心法测定脑脊液MMP-9含量,床边监测aEEG;采用观察表记载临床资料。结果 同一严重程度HIE在不同时相点测定的脑脊液MMP-9含量不同,轻度HIE组各时相点之间MMP-9含量比较差异无统计学意义(P>0.05);中度HIE组及重度HIE组各时相点之间MMP-9含量比较差异有统计学意义(P<0.05);同一时相点不同严重程度HIE测定的脑脊液MMP-9含量也不同,第1天MMP-9含量在三组之间两两比较差异均有统计学意义(P＜0.05)。在第7天时轻度组和中度组,中度组和重度组之间两两比较差异均有统计学意义(P＜0.05)。在第14、21天时,轻度组和重度组之间差异具有统计学意义(P＜0.05)。第21天时相点不同预后的MMP-9之间差异有统计学意义(P＜0.05),MMP-9含量与HIE预后具有弱相关性(P=0.007)。在第1天、第14天和第21天时相点,MMP-9含量变化与60例HIE具有一定的相关性(P<0.05)。结论 脑脊液MMP-9含量与HIE的病情严重性相关联,MMP-9可作为预报HIE早期诊治、预测预后的指标。

关键词: 足月新生儿, 缺氧缺血性脑病, 基质金属蛋白酶-9