Abstract: Objective　To investigate the expression and clinical significance of serum matrix metalloproteinase-9 （MMP-9） in patients with subcortical ischemic vascular disease （SIVD）．Methods　This prospective study included a SIVD group consisting of 115 patients with SIVD who were treated in the Department of Neurology of Affiliated Provincial Hospital of Anhui Medical University from October 2016 to July 2017，and a control group consisting of 69 persons who underwent physical examination in the hospital during the same period and did not have abnormal findings in head MRI.General clinical data were collected，and blood total cholesterol，triglycerides，low-density lipoprotein cholesterol and high-density lipoprotein cholesterol were detected.Fazekas scores of brain white matter lesions and lacunar infarct （LI） counts were assessed on the basis of head MRI.Serum MMP-9 concentrations were detected with enzyme-linked immunosorbent assays.MMP-9 levels and brain injury levels were compared between the two groups，and the correlation between MMP-9 and brain injury was analyzed.Results　The proportions of patients with hypertension and diabetes in the SIVD group were both higher than those of the control group （P<0.05）．The serum level of MMP-9，Fazekas scores，and LI number in the SIVD group were all higher than those in the control group （P<0.05）．Serum MMP-9 levels in patients with SIVD were positively correlated with the Fazekas score and LI number （rs=0.301，rs=0.395，P<0.001）．Multivariate Logistic regression analysis showed that hypertension 〔OR=5.349，95%CI （2.449，11.685）〕，diabetes〔OR=3.008，95%CI （1.265，7.154）〕，and serum MMP-9 level 〔OR=1.014，95%CI （1.009，1.019）〕 were all independent influencing factors for SIVD （P<0.05）．Conclusion　Elevated serum MMP-9 levels may be an independent risk factor for SIVD，and serum MMP-9 levels correlated with the severity of SIVD.This study may provide new directions for the prevention and treatment of cerebrovascular disease.

Key words: Ischemic attack, transient；Matrix metalloproteinase 9；Extracellular matrix；Blood-brain barrier

摘要： 目的　探讨皮质下缺血性血管病（SIVD）患者血清基质金属蛋白酶9（MMP-9）的表达水平及临床意义。方法　选取2016年10月—2017年7月安徽医科大学附属省立医院神经内科收治的SIVD患者115例为SIVD组，选取同期于安徽医科大学附属省立医院体检且颅脑磁共振成像（MRI）未见明显异常的69例体检者为对照组。采集一般临床资料，检测总胆固醇、三酰甘油、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）；根据颅脑MRI表现进行脑白质病变（WML）Fazekas评分和腔隙性脑梗死（LI）计数；采用酶联免疫吸附法检测血清MMP-9水平；比较两组间MMP-9水平、脑损伤程度，并分析MMP-9与脑损伤程度的相关性。结果　SIVD组患者高血压、糖尿病所占比例、血清MMP-9水平、Fazekas评分、LI数量均高于对照组（P<0.05）。SIVD组患者血清MMP-9水平与Fazekas评分、LI数量均呈正相关（rs=0.301、0.395，P<0.001）。多因素Logistic回归分析结果显示，高血压〔OR=5.349，95%CI（2.449，11.685）〕、糖尿病〔OR=3.008，95%CI（1.265，7.154）〕、血清MMP-9水平〔OR=1.014，95%CI（1.009，1.019）〕均是SIVD的独立影响因素（P<0.05）。结论　血清MMP-9水平升高可能是SIVD的独立危险因素，且血清MMP-9水平与SIVD的严重程度具有一定的相关性，可能为脑血管疾病的防治提供新的方向。

关键词: 脑缺血发作, 短暂性；基质金属蛋白酶9；细胞外基质；血-脑脊液屏障