目的 研究CXC趋化因子配体4（CXCL4）、基质金属蛋白酶-9（MMP-9）、微小RNA-24（miR-24）对急性脑梗死（ACI）早期神经功能恶化（END）的预测价值。方法 分别选择2020年1月—2021年6月我院收治的30例ACI早期END患者（ACI+END组）,30例单纯ACI患者（ACI组）,同时期30例健康人群作为对照组,检测受试者CXCL4、MMP-9、miR-24表达情况及存在的相关性,分析血清CXCL4、MMP-9、miR-24表达情况与ACI早期发生END的关系。结果 CXCL4、MMP-9水平在对照组、ACI组、ACI+END组中依次升高,miR-24相对表达量依次降低（P<0.05）。血清CXCL4、MMP-9、miR-24水平在轻度、重度患者中呈升高趋势,miR-24相对表达呈降低趋势（P<0.05）。Logistic回归分析血清CXCL4、MMP-9、miR-24表达异常与ACI早期发生END独立相关（P<0.05）。经Pearson相关性分析发现,CXCL4与MMP-9之间呈正相关（r=0.584,P=0.001）;CXCL4、miR-24之间呈负相关（r=-0.569,P=0.001）,MMP-9、miR-24之间呈负相关（r=-0.567,P=0.001）。ROC曲线显示,与CXCL4、MMP-9、miR-24单项预测相比,三项联合对ACI的关系及对早期END的预测价值较高（P<0.05）。结论 CXCL4、MMP-9、miR-24在ACI发生END时出现异常表达,检测CXCL4、MMP-9、miR-24水平对ACI早期END具有一定预测价值,可尽早制定相关措施干预,提高治疗效率。

Objective To study the predictive value of CXC chemokine ligand 4（CXCL4）,matrix metalloproteinase-9（MMP-9）,microRNA-24（miR-24）in early neurological deterioration（END）of acute cerebral infarction（ACI）．Methods A total of 30 patients with ACI early END（ACI+END group）and 30 patients with ACI only（ACI group）who were admitted to our hospital from January 2020 to June 2021 were selected,and 30 healthy people（control group）who underwent physical examination in our hospital during the same period were selected．Expressions of CXCL4,MMP-9,and miR-24 were detected and their correlations were analyzed,and the relationship between the expressions of serum CXCL4,MMP-9,miR-24 and the early occurrence of END in ACI were analyzed．Results The levels of CXCL4 and MMP-9 were increased in the control group,ACI group and ACI+END group in turn,and the relative expression of miR-24 was decreased in turn,and the differences among the groups were statistically significant（P<0.05）．The levels of serum CXCL4,MMP-9,and miR-24 increased in mild and severe patients,while the relative expression of miR-24 decreased,and the differences between groups were statistically significant（P<0.05）．Logistic regression analysis showed that abnormal expressions of serum CXCL4,MMP-9 and miR-24 were independently correlated with the early occurrence of END in ACI（P<0.05）．After Pearson correlation analysis,it was found that there was a positive correlation between CXCL4 and MMP-9（r=0.584,P=0.001）,a negative correlation between CXCL4 and miR-24（r=-0.569,P=0.001）;a negative correlation between MMP-9 and miR-24（r=-0.567,P=0.001）．The ROC curve showed that compared with the single prediction of CXCL4,MMP-9 and miR-24,the predictive value of the combined prediction on ACI and early END were higher（P<0.05）．Conclusions CXCL4,MMP-9,and miR-24 are abnormally expressed in ACI when END occurs．Detection of CXCL4,MMP-9,and miR-24 levels has certain predictive value for early END of ACI,and relevant measures can be formulated as soon as possible to improve treatment efficiency．

目的 分析稳定期慢性阻塞性肺疾病患者血浆可溶性尿激酶型纤溶酶原激活因子受体(suPAR)、IL-8和MMP-9的水平,探讨其在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者中的临床意义。方法 入选60例稳定期COPD患者设为观察组,再根据肺功能分为Ⅱ级、Ⅲ级及Ⅳ级亚组;同时选取同期健康体检者70例作为对照组,检测两组的血清suPAR、IL-8和MMP-9水平及肺功能,比较观察组跟对照之间的差异,同时比较Ⅱ级、Ⅲ级、Ⅳ级亚组及对照组之间的差异。结果 观察组血清suPAR、IL-8和MMP-9水平高于对照组;Ⅱ级、Ⅲ级及Ⅳ级各亚组的血清suPAR、IL-8和MMP-9均高于对照组;Ⅲ级及Ⅳ级组高于Ⅱ级组;以上差异均有统计学意义(P<0.05)。但Ⅲ级与Ⅳ级比较无差异(P>0.05)。结论 血清suPAR、IL-8和MMP-9在稳定期COPD患者中水平增高,且反映了其严重程度,有望成为COPD病情评估新指标及未来分子水平治疗的新靶点。

Objective To analyze the serum soluble urokinase-type plasminogen activator receptor, IL-8 and MMP-9 levels in stable chronic obstructive pulmonary disease and explore its clinical significance.Methods 60 patitents with stable COPD were selected as the observation group, and subdivided to subgroups stage Ⅱ, Ⅲ and Ⅳ. Meanwhile, 70 healthy individuals were enrolled as the control group. And then suPAR、IL-8 and MMP-9 levels and pulmonary function were measured in both groups. The differences between both groups as well as all the subgroups were compared.Results The suPAR level of the observation group was higher than that of the control group. Also, compared with the control group, stage Ⅱ, Ⅲ and Ⅳ subgroups showed much higher level of suPAR,IL-8,MMP-9. And it was higher in stageⅢand Ⅳthan in stageⅡ. However, there was no difference between Stage Ⅲ and Ⅳ.Conclusion The suPAR,IL-8 and MMP-9 level are higher in COPD patients and are related to the severity of stages. Therefore, it could be an appropriate biomarker as well as a novel target for future therapy and further evaluation.