摘要： 目的 观察颅脑创伤患者外周血游离CD147及其诱导产物基质金属蛋白酶-9（MMP-9）动态变化，并探讨其表达变化与短期预后的关系。方法 纳入2014年5月至2016年12月天津医科大学第二医院收治的39例颅脑创伤患者，酶联免疫吸附试验测定外周血游离CD147和MMP-9表达变化，明胶酶谱法测定MMP-9活性，出院时采用Glasgow预后分级（GOS）评价预后。结果 男性与女性患者出院时GOS评分差异无统计学意义（2.63 ±1.28对2.57 ±1.14；t=0.161，P=0.873）；不同年龄段出院时GOS评分差异具有统计学意义（t=2.191，P=0.038），> 60岁患者GOS评分低于< 40岁（t=2.645，P=0.014）和40~60岁（t=2.320，P=0.029）患者。根据GOS评分分为预后良好组（GOS评分 ≥ 3，25例）和预后不良组（GOS评分< 3，14例），预后不良组患者外周血游离CD147[（5.07 ±1.89）ng/ml对（10.37 ±1.69）ng/ml；t=2.080，P=0.048]和MMP-9[（41.55 ±4.67）ng/ml对（75.23 ±5.18）ng/ml；t=2.512，P=0.019]水平高于预后良好组。偏相关分析结果显示，出院时GOS评分与外周血游离CD147（r=-0.473，P=0.000）和MMP-9 （r=-0.435，P=0.036）水平呈负相关。结论 颅脑创伤患者外周血游离CD147及其诱导产物MMP-9水平越高、预后越差，可以作为提示颅脑创伤患者预后不良的重要指标。

关键词: 脑损伤, 创伤性, 细胞外基质蛋白质类, 基质金属蛋白酶9, 预后, 酶联免疫吸附测定

Abstract: Objective To observe the dynamic changes of free CD147 and its induced product matrix metalloproteinase-9 (MMP-9) of patients with traumatic brain injury (TBI) in peripheral blood, and to explore the relationship between its expression changes and short-term prognosis. Methods Thirty-nine patients with TBI admitted to the Second Hospital of Tianjin Medical University from May 2014 to December 2016 were included in the study. The expression changes of free CD147 and MMP-9 in peripheral blood were determined by enzyme-linked immunosorbent assay (ELISA), and the activity of MMP-9 was determined through gelatin zymography. The prognosis was evaluated via Glasgow Outcome Scale (GOS) at discharge. Results There was no significant difference in GOS score between male and female patients at discharge (2.63 ±1.28 vs. 2.57 ±1.14; t=0.161, P=0.873). There was a statistically significant difference in GOS score between different age groups at discharge (t=2.191, P=0.038). The GOS scores of patients over 60 years old were lower than those of patients under 40 years old (t=2.645, P=0.014) and those between 40 and 60 years old (t=2.320, P=0.029). According to the GOS score, they were divided into a good prognosis group (GOS score ≥ 3, n=25) and a poor prognosis group (GOS score < 3, n=14). Free CD147 in peripheral blood of patients with poor prognosis[(5.07 ±1.89) ng/ml vs. (10.37 ±1.69) ng/ml;t=2.080, P=0.048] and MMP-9[(41.55 ±4.67) ng/ml vs. (75.23 ±5.18) ng/ml; t=2.512, P=0.019] were higher than the good prognosis group. Correlation analysis showed that the GOS score at discharge was negatively correlated with free CD147 (r=-0.473, P=0.000) and MMP-9 (r=-0.435, P=0.036) in peripheral blood. Conclusions The higher the level of free CD147 and its induced product MMP-9 in peripheral blood of patients with TBI, the worse the prognosis, which indicated that free CD147 and MMP-9 can be used as important indicators for poor prognosis of patients with TBI.

Key words: Brain injuries, traumatic, Extracellular matrix proteins, Matrix metalloproteinase 9, Prognosis, Enzyme-linked immunosorbent assay