基质金属蛋白酶-9与急性冠状动脉综合征的临床相关性研究

目的:探讨血清基质金属蛋白酶 9(MMP 9)与急性冠状动脉综合征(ACS)的关系。方法:经冠状动脉造影(CAG)确诊的冠心病患者85例,其中ACS患者(ACS组)58例,包括急性心肌梗死(AMI)22例,不稳定型心绞痛(UAP)36例;稳定型心绞痛组(SAP组)27 例;另设对照组 24 例。用酶联免疫吸附法(ELISA)测定各病例造影前及行PTCA者术后血清MMP 9浓度。结果:在造影前,ACS组、SAP组及对照组血清 MMP 9 浓度分别为(26.85±6.25)、(17.35±7.12)、(16.83±5.92)μg/L;此外,ACS组内 AMI和 UAP患者血清 MMP 9 浓度分别为(32.56±6.55)、(24.78±5.76)μg/L。AMI及UAP患者与SAP组之间MMP 9浓度差异有统计学意义,SAP组与对照组之间差异无统计学意义;ACS组内,AMI与UAP患者之间差异无统计学意义。血清 MMP 9 水平与C反应蛋白(CRP)、WBC、冠状动脉病变评分、冠状动脉狭窄程度之间呈明显的正相关,与冠状动脉病变支数、肌钙蛋白 I(cTnI)、肌酸激酶同工酶(CK MB)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL C)、低密度脂蛋白胆固醇(LDL C)、PLT间无明显相关性。PTCA术后 l d MMP 9 浓度均较术前要明显升高。结论:ACS患者血清MMP 9浓度明显升高,其水平与冠状动脉内粥样硬化斑块的稳定性密切相关,提示其有助于冠心病的危险分层,对评价     

代谢综合征与老年人轻度认知功能障碍相关性研究进展

<正>代谢综合征(MS)由遗传和环境因素共同作用所引起,包括中心性肥胖、高血压、高血糖症、血脂代谢紊乱,高甘油三酯(TG)血症及高密度脂蛋白胆固醇(HDL-C)低下~〔1〕。近年越来越多的研究表明MS及其组分与老年人轻度认知功能障碍(MCI)的发生密切相关。MCI是老年期痴呆(AD)的预警信号,而AD至今没有很好的治疗方法。本文就国内外对整体MS及其各组分与MCI关系的研究进行综述。     

基质金属蛋白酶-9与肺纤维化

基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)是一种金属离子依赖的蛋白酶,通过多种途径参与特发性肺纤维化(idiopathic pulmonary fibrosis,IPF)的发病机制,本文就MMP-9的基本特性及其与肺纤维化的关系进行综述。     

老年人轻度认知功能障碍与睡眠障碍的相关性研究

目的 探究老年人轻度认知功能障碍(MCI)与睡眠障碍的相关性. 方法 纳入2018年3月至2020年4月就诊于我院的220例存在认知功能障碍的老年患者,其中单领域遗忘组65例,多领域遗忘组97例,非遗忘组58例,应用匹兹堡睡眠量表(PSQI)和日间嗜睡量表(ESS)评价患者主观睡眠情况,多导睡眠监测客观分析患者睡眠质量...     

老年人轻度认知功能障碍与睡眠障碍的相关性研究

目的 探究老年人轻度认知功能障碍(MCI)与睡眠障碍的相关性。 方法 纳入2018年3月至2020年4月就诊于我院的220例存在认知功能障碍的老年患者,其中单领域遗忘组65例,多领域遗忘组97例,非遗忘组58例,应用匹兹堡睡眠量表(PSQI)和日间嗜睡量表(ESS)评价患者主观睡眠情况,多导睡眠监测客观分析患者睡眠质量,分析MCI与睡眠障碍的相关性。 结果 220例患者中PSQI平均得分为(17.1±3.9)分,相关性分析得出单领域遗忘组与睡眠质量、睡眠时间、日间功能障碍、PSQI总分、觉醒指数、ESS评分呈正相关( r _s值分别为0.356、0.324、0.351、0.412、0.361、0.327,均 P<0.05);多领域遗忘组与睡眠质量、睡眠时间、睡眠障碍评分、催眠药物评分、PSQI总分、觉醒指数、浅睡眠期、ESS评分呈正相关( r _s值分别为0.283、0.323、0.346、0.401、0.379、0.412、0.228、0.251,均 P<0.05),非遗忘组与睡眠时间、催眠药物评分、PSQI总分、快眼动睡眠障碍、浅睡眠期呈正相关( r _s分别为0.348、0.307、0.391、0.355、0.228,均 P<0.05)。 结论 老年MCI类型与睡眠障碍存在相关性,不同类型MCI与不同睡眠障碍因素相关性不同。     

基质金属蛋白酶-9与脑血管病

基质金属蛋白酶-9(matrix metalloproteinase,MMP-9)可降解细胞外基质中的Ⅳ型胶原,在脑基底膜的降解中起主要作用.组织金属蛋白酶抑制剂-1(tissue inhibitor of metalloproteinase,TIMP-1)是天然的MMP-9特异性抑制剂.MMP-9与TIMP-1平衡关系的失调与缺血性和出血性脑损伤有关,与动脉瘤、动脉粥样硬化等的形成和发展也有关.因此,人为地调节MMP-9与TIMP之间的平衡,有可能成为治疗脑血管病的新途径.     

金属基质蛋白酶-9与食管癌相关性的研究进展

食管癌可发生早期淋巴结及血行转移的特性使其表现出临床进展迅速并且预后很差的特性。研究表明,癌细胞浸润转移能力与其诱导产生的蛋白酶降解细胞外基质（ECM）、基底膜的能力密切相关,因此基质金属蛋白酶（MMPs）引起了肿瘤学研究者们的极大兴趣。     

血清基质金属蛋白酶-9与冠心病相关性的临床研究

目的　观察冠心病患者基质金属蛋白酶 - 9(MMP- 9)血清水平以及与冠状动脉内径狭窄程度的关系。探讨MMP- 9在冠心病发病中所起的作用。方法　行冠状动脉造影术诊断为冠心病者 32例 ,另选 30例正常人为对照组 ,用 EL ISA法测定两组之间血清 MMP- 9水平 ,并探讨 MMP- 9与冠状动脉内径狭窄程度的关系。结果　冠心病组血清 MMP- 9水平高于正常对照组 (P<0 .0 1) ,冠状动脉内径狭窄程度与基质金属蛋白酶浓度值呈正相关 (r=0 .6 0 1,P<0 .0 1)。结论　 MMP- 9可能参与了冠心病的发生发展过程     

核转录因子-κB-基质金属蛋白酶-9信号通路在糖尿病大鼠认知功能障碍中的作用

目的探讨核转录因子-κB(NF-κB)-基质金属蛋白酶-9(MMP-9)通路在糖尿病(DM)大鼠认知功能障碍中的作用。方法采用55 mg/kg链脲激酶(STZ)单次腹腔注射诱导DM大鼠模型,随机分为3组(每组10只):对照组、DM组和DM吡咯烷二硫氨基甲酸酯(PDTC)治疗组(DM+PDTC组)。DM+PDTC组予以PDTC[150 mg/(kg·d)]持续灌胃6周。6周后采用Morris水迷宫检测学习记忆功能,选取上述同样处理的3组(每组6只)用于检测海马MMP-9及NF-κB的蛋白表达。结果 DM组的潜伏期在训练的第3、4、5天较对照组明显延长(P<0.05),而PDTC治疗可明显改善DM引起的潜伏期延长(P<0.05)。在空间探索试验中,目标象限的停留时间百分比比较,DM组较对照组明显下降(P<0.05),而DM+PDTC组较DM组明显增加(P<0.05)。DM组海马MMP-9和NF-κB的表达较对照组显著升高(P<0.05),而DM+PDTC组NF-κB的表达与对照组比较无显著性差异(P>0.05)。DM+PDTC组的MMP-9的表达较DM组显著降低(P<0.05),但较对照组仍显著升高(P<0.05)。结论DM可能通过激活NF-κB信号通路,从而部分上调MMP-9的表达,从而导致认知功能障碍的发生。     

基质金属蛋白酶2、基质金属蛋白酶9与急性肺损伤关系的研究进展

急性肺损伤是由多种肺内外因素如严重创伤、感染、休克、脓毒症和大量输血等原因引起的弥漫性肺实质损伤.各种原因引起一系列炎症细胞在肺内聚集和活化,释放细胞因子、生长因子及其他炎症介质,引起基质金属蛋白酶(MMP)的合成和活化.MMP-2、MMP-9通过破坏基底膜、促进炎症过程中有关细胞的迁移以及细胞外基质重建,在急性肺损伤的发病过程中发挥重要作用.研究MMP-2,MMP-9在急性肺损伤中的作用机制,对于急性肺损伤的防治具有重要意义.     

蒙特利尔认知评估量表在军队离退休人员轻度认知功能障碍中的应用

目的应用蒙特利尔认知评估（MOCA）量表对西安地区军队离退休人员进行轻度认知功能障碍（MCI）的筛查。方法随机、整群抽样选取西安市9个干休所304名离退休干部,同时进行个人信息、患病情况、MOCA量表、简易智能状态检查（MMSE）量表、日常活动能力（ADL）量表、抑郁自评（CES-D）量表、匹兹堡睡眠质量（PSQI）量表调查。结果西安干休所离退休干部MCI发生率为64．8％;80岁以上老年人MCI的发生率高于70岁组（P〈0．05）;教育年限小于6年者MCI的发生率高于7～12年及12年以上者（P〈0．05）;不参加体育锻炼者MCI的发生率高于经常参加体育锻炼者（P〈0．01）;有脑卒中者MCI的发生率高于无脑卒中者（P〈0．05）;MOCA量表得分与MMSE量表得分呈正相关（r=0．81）,与ADL量表、CES-D量表得分呈负相关,与PSQI量表得分无显著相关。结论MOCA量表与相关评估量表具有相关性,测量方便,可行性好,能够用于军队离退休干部人群中MCI的筛查。     

Cognitive, extrapyramidal, and magnetic resonance imaging predictors of functional impairment in nondemented older community dwellers: the Sydney Older Person Study

OBJECTIVES: To identify the clinical correlates of functional incapacity in the community living "old-old." DESIGN: Cross-sectional. SETTING: Community-based. PARTICIPANTS: One hundred six nondemented people aged 80 to 94. MEASUREMENTS: Participants were medically and cognitively assessed, underwent magnetic resonance imaging scanning (MRI), and were interviewed regarding their functional status: activities of daily living (ADLs), instrumental ADLs (IADLs), and the complex IADL functions of reading, hobbies, and socializing. RESULTS: Dependency in IADLs, but not ADLs, was present. After controlling for age, sex, and education, extrapyramidal (EP) signs were significantly associated with two of the three IADLs, with EP signs comprising a composite score of 10 EP signs (e.g., resting tremor) and a 5-meter timed walk. Cognitive test performance on a range of tests was also associated with functional status. A hierarchical model confirmed the association between the EP signs and cognitive test performance and functional scores, but no "pattern" of cognitive association emerged. Hippocampal volume was associated with socializing. CONCLUSION: This study has shown that many nondemented very old people living in the community are losing capacity to perform IADL functions and that areas of incapacity are associated with the presence of EP signs and impaired cognition. These results highlight the need for health workers to include an assessment of EP and cognitive status in their evaluation of older persons living in the community, even in the context of a lack of dementia diagnosis. Furthermore, it signifies the need to directly evaluate IADL function to identify need for intervention and support if required. This group of old-old individuals may now be considered the "survivors" of their cohort, and early detection of the difficulties they are experiencing will enable clinicians to respond appropriately, thus providing them a higher quality of life for their years to come.     

多病共存住院老年人常见慢性病对轻度认知功能障碍的影响

目的 分析多病共存住院老年人常见慢性病对轻度认知功能障碍（MCI）的影响。方法 选择新疆医科大学第一附属医院2022年1月至2023年8月多病共存住院老年人1 591例,收集人口学资料、生化结果、病史资料、量表评估等信息。参照MCI诊断标准将多病共存住院老年人分为非MCI组（n=1 211例）和MCI组（n=380例）。采用SPSS 26.0软件进行数据分析。根据数据类型,组间比较分别采用非参数检验及χ²检验。采用多因素logistic回归分析多病共存住院老年人常见慢性病对MCI的影响因素。结果 多病共存住院老年人MCI检出率为23.88%（380/1 591）。MCI组和非MCI组多病共存住院老年人在年龄、文化程度、婚姻状况、居住情况、空腹血糖、肌酐、尿酸、甘油三酯、血清总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、多病共存、用药种数、高血压、糖尿病、冠心病、脑血管病、慢性阻塞性肺疾病、甲状腺功能减退、日常生活能力评分、Morse跌倒风险评分、Fried衰弱量表评分方面比较,差异均有统计学意义（均P<0.05）。logistic回归分析结果显示：多病共存住院老年人常见慢性病如糖尿病（OR=1.590,95%CI 1.083～2.335）、冠心病（OR=2.199,95%CI 1.571～3.078）、脑血管病（OR=1.603,95%CI 1.113～2.310）、慢性阻塞性肺疾病（OR=1.794,95%CI 1.222～2.634）、甲状腺功能减退（OR=2.489,95%CI 1.597～3.879）、多病共存数量增加（OR=2.711,95%CI 2.292～3.206）是多病共存住院老年人发生MCI的危险因素（均P<0.05）。结论 多病共存住院老年人MCI检出率较高,常见慢性病如糖尿病、冠心病、脑血管病、慢性阻塞性肺疾病、甲状腺功能减退、多病共存数量增加是多病共存老年人发生MCI的危险因素。     

Mild cognitive impairment: epidemiology and dementia risk in an elderly Italian population

OBJECTIVES: To investigate prevalence and incidence of mild cognitive impairment (MCI) and its risk of progression to dementia in an elderly Italian population.
DESIGN: Longitudinal.
SETTING: Population-based cohort aged 65 and older resident in an Italian municipality.
PARTICIPANTS: A total of 1,016 subjects underwent baseline evaluation in 1999/2000. In 2003/04, information about cognitive outcome was collected for 745 participants who were free of dementia at baseline.
MEASUREMENTS: MCI (classified as with or without impairment of the memory domain), dementia, Alzheimer's dementia (AD), and vascular dementia (VaD) diagnosed according to current international criteria.
RESULTS: Overall prevalence of MCI was 7.7% (95% confidence interval (CI)=6.1–9.7 %) and was greater with older age and poor education. During 4 years of follow-up, 155 incident MCI cases were diagnosed, with an incidence rate of 76.8 (95% CI=66.8–88.4) per 1,000 person-years. Approximately half of prevalent and incident MCI cases had memory impairment. Compared with normal cognition, multivariable-adjusted risk for progression from MCI with memory impairment to dementia was 4.78 (95% CI=2.78–8.07) for any dementia, 5.92 (95% CI=3.20–10.91) for AD, and 1.61 (95% CI=0.37–7.00) for VaD. No association with dementia risk was found for MCI without memory impairment. Approximately one-third of MCI cases with memory impairment did not progress to dementia.
CONCLUSION: MCI occurs often in this elderly Italian cohort and is associated with greater risk of AD, but only when the impairment involves the memory domain. However, a substantial proportion of MCI cases with memory impairment do not progress to dementia.     

农村老年人轻度认知功能障碍流行病学调查

目的了解湖南省慈利县农村老年人轻度认知功能障碍（MCI）的流行病学特征。方法采用随机整群分层分阶段抽样的方法对2011年6月至12月湖南省慈利县6个乡镇、年龄≥60岁的老年人进行现况调查及筛查,完成调查问卷及简易精神状况量表（MMSE）;临床诊断,对有明显记忆障碍者及MMSE分数低于界值者进一步进行临床检查,并由2名神经科医师进行最后诊断;同时进行总体衰退量表、Hachinski缺血指数量表、临床痴呆评定量表等评定。结果调查1367名,男性678名,女689名,MMSE阳性者178例,占13．02％,确诊为MCI者139例,患病率为10．17％;不同年龄段、文化程度、职业、居住及文化生活情况的老年人,其MCI患病率差异均有统计学意义（P〈O．05）。结论高龄、低文化水平、嗜烟、不喝酒或嗜酒、单独居住等因素会增加患MCI的危险。     

Montreal Cognitive Assessment Arabic version: Reliability and validity prevalence of mild cognitive impairment among elderly attending geriatric clubs in Cairo

Aim:   Mild cognitive impairment (MCI) is a clinical label which includes elderly subjects with memory impairment and with no significant daily functional disability. MCI is an important target for Alzheimer's dementia prevention studies. Data on the prevalence and incidence of MCI varies greatly according to cultural difference. The first aim of this study was to assess the reliability and validity of Montreal Cognitive Assessment (MoCA) Arabic version in MCI detection. The second was to determine the prevalence of MCI among apparently healthy elderly people attending geriatric clubs in Cairo.
Methods:   In stage I reliability & validity of MoCA Arabic version were assessed in reference to Cambridge Cognitive Examination (CAMCOG). In stage II prevalence of MCI was estimated using Arabic MoCA among apparently healthy elderly attending geriatric clubs. These geriatric clubs were randomly selected from different regions in Cairo governorate.
Results:   Test–retest reliability data of the Arabic MoCA were collected approximately 35.0 ± 17.6 days apart. The mean change in Arabic MoCA scores from the first to second evaluation was 0.9 ± 2.5 points, and correlation between the two evaluations was high (correlation coefficient = 0.92, P  < 0.001). The internal consistency of the Arabic MoCA was good, yielding a Cronbach's α on the standardized items of 0.83. In diagnosing mild cognitive impairment, the Arabic MoCA showed 92.3% sensitivity and 85.7% specificity. The prevalence of MCI among elderly subjects attending geriatric clubs in Cairo is 34.2% and 44.3% of healthy men and women, respectively.
Conclusion:   Older age, female sex and less education are the independent risk factors for MCI among apparently healthy elderly subjects attending geriatric clubs in Cairo.