Influence of kallilrein on cerebral hemodynamics and matrix metalloproteinases in patients with large-area cerebral infarction
Meng Yun
Zhu Yanliang
Abstract：Objective To explore the influence of kallilrein on cerebral hemodynamics,matrix metalloproteinases (MMPs) and the clinical efficacy in patients with large-area cerebral infarction.Methods Totally 127 patients with large-area cerebral infarction from March 2011 to September 2014 were enrolled and randomly divided into control group (64 cases) receiving conventional treatment and observation group (63 cases) administrated with kallilrein (0.15 PNA unit dissolved in 0.9％ sodium chloride injection,40 drops/min,1 time/d for 14 d)in addition to conventional treatment.The parameters of cerebral hemodynamics and the levels of MMP-1,MMP-2,MMP-9 before trcatment,7 d,14 d,21 d,28 d and 3 months after treatment were compared between the two groups.The short-term (28 d after treatment) and long-term (3 months after treatment) outcomes were compared between the two groups.Results No changes were shown regarding the mean velocity (Vm),peak systolic velocity ratio of anterior cerebral artery and posterior cerebral artery after treatment in both groups (all P ＞ 0.05).Compared with those before treatment,the Vm of middle cerebral artery (MCA) and terminal internal carotid artery (TICA) 7 d,14 d,21 d,28 d and 3 months after treatment,the mean flow (Qm) 14 d,21 d,28 d and 3 months after treatment were significantly improved in both control group [Vm of MCA:(27 ± 10),(28 ± 13),(30 ± 13),(35 ±12),(36 ±9) cm/s vs (24±8) cm/s,Vm of TICA:(40±13),(41 ±8),(43 ± 13),(44±13),(45±10) cm/s vs (35±14) cm/s,Qm:(6.8±2.3),(7.2±2.1),(7.6±2.4),(8.0±1.7) ml/min vs (6.2 ± 1.8) ml/min] and observation group [Vm of MCA:(27 ±5),(35 ±8),(39 ± 11),(45 ± 10),(46 ± 9) cm/svs (24 ±7) cm/s,Vm of TICA:(41 ±10),(45 ±9),(49±14),(54±12),(55 ±9) cm/s vs (34 ±8) cm/s,Qm:(7.6 ±2.4),(8.1 ± 1.2),(8.8 ± 1.4),(9.0± 1.2) ml/min vs (6.5 ± 1.3) ml/min] (all P ＜0.05); there were significantly differences regarding those outcomes between the two groups 14 d after treatment.Compared with those before treatment,the pulsatility index (PI) was improved 7 d,14 d,21 d,28 d and 3 months after treatment in observation group (1.41 ± 0.27,1.21 ± 0.44,1.11 ± 0.21,1.03 ± 0.17,1.10 ±0.21 vs 1.75 ±0.36) ; it was improved 21 d,28 d and 3 months after treatment in control groups (1.51 ± 0.14,1.38 ±0.15,1.27 ±0.08 vs 1.81 ±0.12) ; there were significantly differences regarding PI between the two groups after treatment (all P ＜ 0.05).Fourteen days after treatment,the dynamic resistance was improved significantly in both control group (301 ±84,285 ±78,256 ±96,250±77 vs 326 ±90,362 ±72,339 ±79,321 ± 85,311 ± 74 vs 389 ± 84) and observation group (283 ± 92,264 ± 87,228 ± 85,225 ± 83 vs 327 ± 74; 342 ± 94,312 ±86,287 ±75,285 ±58 vs 391 ±96),with significant differences between the two groups (all P ＜ 0.05).The levels of MMP-1,MMP-2,and MMP-9 in observation group were significantly lower than those in control group since 14 d after treatment,all lower than pretreatment (all P ＜ 0.05).The short-term and long-term marked rates in observation group were higher than those in control group [34.9％ (22/63) vs 15.6％ (10/64),47.6％ (25/63) vs 15.6％ (10/64)],so did the total effective rates [73.0％ (46/63) vs 53.1％ (34/64),84.1％ (53/63) vs 62.5％ (40/64)] (P ＜0.05).Conclusion Kallilrein can improve the parameters of cerebral hemodynamics and the MMPs level,which has significant therapeutic effects in the short and long term.
Keywords：KallilreinLarge-area cerebral infarctionHemodynamicsMatrix metalloproteinases
Publication Date：2015-09-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：6( 1300-1305 )