目的:探讨血清基质金属蛋白酶-9(matrix metalloproteinases-9，MMP-9)水平与脑微出血(cerebral microbleeds，CMBs)部位及严重程度的相关性。方法:2019年1月至2020年8月经新乡医学院第一附属医院神经内科收治并予以头颅MRI检测有CMBs患者60例作为CMBs组，以同期门诊体检无神经系统疾病的健康者60例作为对照组，收集两组一般临床资料，生化指标，酶联免疫吸附法检测血清MMP-9的水平，并根据磁敏感加权成像(susceptibility-weighted imaging，SWI)将CMBs数量分为1级(n n＝24)，2级(n n＝19)，3级(n n＝17)，根据脑微出血解剖评分量表(microbleed anatomical rating scale，MARS)将CMBs部位分为脑叶组(n n＝19)、深部或幕下组(n n＝17)和混合组(n n＝24)，分析血清MMP-9水平与CMBs部位及其严重程度的关系。使用SPSS 19.0软件进行统计方差分析、n t检验、秩和检验进行组间比较，影响因素分析采用Logistic回归分析，相关分析采用Pearson相关分析和Spearman相关分析。n 结果:CMBs组MMP-9水平明显高于对照组[208.13(142.25，285.88) μg/L，149.50(93.40，186.51)μg/L]，差异有统计学意义(n P<0.05)。MMP-9水平是CMBs的危险因素(n β＝1.322，n OR＝3.750，95%n CI＝2.038～7.997，n P＝0.002)。不同严重程度CMBs患者MMP-9水平差异有统计学意义[147.55(109.25，266.47)μg/L，242.12(147.55，288.80)μg/L，270.42(203.43，364.27)μg/L，n P＝0.017]。MMP-9水平与CMBs个数呈正相关(n r＝0.371，n P＝0.003)。不同出血部位CMBs的MMP-9水平差异有统计学意义[249.77(158.43，338.46)μg/L，188.83(138.52，243.15)μg/L，210.65(144.25，255.78)μg/L](n P＝0.013)，MMP-9水平是脑叶CMBs的危险因素(n β＝0.401，n OR＝1.122，95%n CI＝1.004～1.204，n P＝0.036)。n 结论:血清MMP-9水平升高可能是CMBs的危险因素，尤其是脑叶CMBs，且MMP-9水平与脑微出血严重程度呈正相关。“,”Objective:To investigate the relationship between serum matrix metalloproteinase-9 (MMP-9) level and the location and severity of bleeding in patients with cerebral microbleeds(CMBs).Methods:A total of 60 CMBs patients admitted to the Department of Neurology of the First Affiliated Hospital of the Xinxiang Medical University from January 2019 to August 2020 were selected as subjects as the CMBs group, and 60 healthy controls without nervous system diseases in outpatient physical examination during the same period were selected as the control group. The clinical data and biochemical indicators of the two groups were collected. Serum MMP-9 levels were measured by enzyme linked immunosorbent assay (ELISA). According to susceptibility weighted imaging (SWI), CMBs patients were divided into grade 1 group (n n=24), grade 2 group (n n=19) and grade 3 group (n n=17), and according to the micro analytical rating scale (MARS), the CMBs patients were divided into the lobar group (n n=19), the deep or infratentorial group (n n=17) and the mixed group (n n=24).The relationship between serum MMP-9 level and the location and severity of CMBs was analyzed. SPSS 19.0 software was used for data statistical analysis.One-way ANOVA, n t-test and rank sum test were used for comparison. Logistic regression analysis was used to analyze the influencing factors. Pearson correlation analysis and Spearman correlation analysis were used for correlation analysis.n Results:The level of MMP-9 in CMBs group was significantly higher than that in control group (208.13(142.25, 285.88) μg/L, 149.50(93.40, 186.51)μg/L), and the difference was statistically significant ( n P<0.05). Serum MMP-9 level was a risk factor of CMBs (n β=1.322, n OR=3.750, 95%n CI=2.038-7.997, n P=0.002). The difference of level of MMP-9 in different severity of CMBs was statistically significant (147.55(109.25, 266.47)μg/L, 242.12(147.55, 288.80)μg/L, 270.42(203.43, 364.27)μg/L,n P=0.017). Serum MMP-9 level was positively correlated with the number of CMBs (n r=0.371, n P=0.003). The difference of MMP-9 level of CMBs in different locations were statistically significant (249.77(158.43, 338.46)μg/L, 188.83(138.52, 243.15)μg/L, 210.65(144.25, 255.78)μg/L,n P=0.013). The increased serum MMP-9 level was a risk factor for CMBs(n β=0.401, n OR=1.122, 95%n CI=1.004-1.204, n P=0.036).n Conclusion:The increased level of serum MMP-9 may be a risk factor of CMBs, especially for CMBs in cerebral lobesand, and the level of MMP-9 is positively correlated with the severity of CMBs.