Changes in serum MMP-9,BDNF and IL-18 levels in early cerebral oedema after hypertensive cerebral hemorrhage
Objective To analyze the changes of serum matrix metalloproteinase-9(MMP-9),brain-derived neurotrophic factor(BDNF)and interleukin-18(IL-18)in early brain edema after hypertensive cerebral hemorrhage.Methods In this study,a retrospective,large-sample,controlled method was used to screen 224 hypertensive cerebral hemorrhage patients admitted to the Department of Neurosurgery of the Sec-ond People's Hospital of Hengshui City as the cerebral oedema group from December 2020 to December 2021.Patients were classified into 102 cases of medium-high cerebral oedema and 122 cases of mild cerebral oedema according to the size of the cerebral oedema index after the operation.Additionally,118 healthy individuals who had medical check-ups in the same period atthe hospital were selected as the normal control group.To compare the serum levels of MMP-9,BDNF,and IL-18 in the cerebral oedema group and the normal control group,trends in these levels at 24 h,36 h,48 h and 72 h after admission to the hospital were analyzed.Uni-variate analysis was used to identify factors affecting the severity of cerebral oedema,and multivariate analysis was conducted to assess factors independently associated with the severity of cerebral oedema.Results The levels of serum MMP-9 and IL-18 in the cerebral oedema group were higher than those in the control group,while the BDNF level was lower than that of the control group,and the difference was statistically significant(P<0.05).As time progressed in the cerebral oedema group,the levels of MMP-9 and IL-18 continued to in-crease significantly(P<0.05).In the cerebral oedema group,over 48 hours,the level of BDNF gradually de-creased,and the difference was statistically significant(P<0.05).When comparing the duration of hyperten-sion,systolic blood pressure at admission,diastolic blood pressure at admission,GCS score,preoperative pu-pil changes,operation time,hematoma volume,operation method,and levels of MMP-9,BDNF,and IL-18 between the high cerebral oedema group and the mild cerebral oedema group,the difference was statistically significant(P<0.05).Factors with a P value of less than 0.05 in the univariate analysis were included in the bi-nary logistic regression model.After adjustment,it was determined that a long duration of hypertension,low GCS score,extended operation time,high hematoma volume,traditional non-microscopic surgery,high lev-els of MMP-9 and IL-18,and low levels of BDNF were risk factors that influenced the severity of cerebral oe-dema in the early stages of hypertensive cerebral hemorrhage(P<0.05).Conclusion Serum levels of MMP-9,BDNF,and IL-18 are closely related to the occurrence of early cerebral oedema after hypertensive cerebral hemorrhage.Timely and close monitoring of changes in the above indicators is of great significance in reducing the degree of cerebral oedema.
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