脑梗死患者颈动脉粥样硬化斑块不稳定性标志物的临床研究

The Marker of Unstable Carotid Atheromatous Plaque in Cerebral Infarction Patients.

目的寻找脑梗死患者颈动脉粥样硬化斑块不稳定性的临床标志物。方法对80例脑梗死患者和20例正常人颈动脉进行彩色多普勒超声检查,结合颈内动脉系统四血管微栓子的同步监测及血浆MMP-9水平的测定,确定血浆MMP-9能否作为颈动脉粥样硬化斑块不稳定的临床标志物。结果80例脑梗死患者中有颈动脉粥样硬化斑块的为56例,占70.0%,其中不稳定斑块为19例,占33.9%,10例TCD微栓子阳性均属于不稳定性斑块组,脑梗死患者血浆MMP-9水平明显高于正常人(P<0.01),微栓子阳性患者又显著高于阴性患者(P<0.01)。结论血浆MMP-9参与了脑梗死的病理生理过程,血浆MMP-9水平增高易导致粥样斑块不稳定从而产生微栓子。MMP-9可能是颈动脉粥样硬化斑块不稳定的临床标志物。

Objective To investigate the marker of unstable carotid atheromatous plaque in cerebral infarction patients. Methods The Doppler ultrasonography, transcranial Doppler- detected microemboli and plasma matrix metalloproteinase- 9 （ MMP - 9） level were detected in 80 cerebral infarction patients and 20 healthy people. Results Among 80 cerebral infarction patients, 56 cases（70.0% ） had carotid atheromatous plaque, 19 cases of 56 cases （33.9%） was unstable carotid atheromatous plaque. 10 microemboli - positive patients was all in unstable carotid atheromatous plaque group. The level of plasma MMP- 9 was significantly higher in cerebral infarction group than in control group （ P 〈 0.01 ）, it was especially higher in microemboli - positive patients. Conclusions The results indicated that plasma MMP- 9 participates cerebral infarction pathophysiology process, rise of plasma MMP - 9 can result in unstablility of carotid atheromatous plauee consequently bring microemboli. MMP- 9 may be a clinical marker of unstable carotid athromatous plaque.