颈动脉斑块类型与MMP-9的相关性研究

Relationship between MMP-9 and different types of carotid plaque

目的通过对不同类型颈动脉斑块患者进行分型并检测其血浆基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)水平,来观察颈动脉斑块易损性与MMP-9的相关性。方法对64例颈动脉斑块患者行颈部血管B超、TCD、头颅CT、MRI、DSA检查及神经功能评分(NIHSS),对患者颈动脉斑块进行分型,并检测其血浆MMP-9、C-反应蛋白(CRP)水平。结果血浆MMP-9水平与斑块易损性呈正相关(r=0.92,P<0.01),即血浆MMP-9水平越高,斑块的稳定性越低。CRP在实验组显著高于对照组,实验组中B、C组显著高于A组(P<0.01),而B组和C组比较无统计学意义(P>0.05),提示CRP在颈动脉斑块的患者会升高,但它与颈动脉斑块的易损性的相关性不如MMP-9。结论颈动脉斑块易损性与血浆MMP-9水平呈正相关。我们可以通过影像学及临床检查结合血浆MMP-9水平来判断颈动脉斑块易损性。MMP-9作为易损斑块的潜在血清标志物,在缺血性脑血管病的预防、诊断和治疗上有积极的临床意义。

Objective To observe blood plasma matrix metalloproteinase-9 （MMP-9） of the patients with different types of carotid plaque and investigate the relationship between MMP-9 and carotid plaque vulnerability. Methods Totally 64 patients were examined by CDI, TCD, cranium CT, MRI, DSA and nerves function score （NIHSS） to judge their types of carotid plaque. Their plasma levels of MMP-9 and C-reactive protein （CRP） were detected. Results Plasma MMP-9 had direct correlation with plaque vulnerability（r =0. 92 ,P 〈 0. 01 ）, viz, the higher blood plasma MMP-9 level, the more vulnerable of the plaque was. Plasma CRP in carotid plaque group was significantly higher than those in health individuals, and those of patients with vulnerable and to-be-vulnerable plaque were higher than those of patients with non-vulnerable plaque （ P 〈 0. 01 ）, but there was no statistically significant between the former 2 groups. Conclusion There is a direct correlation of plasma MMP-9 with carotid plaque vulnerability. Carotid plaque vulnerability can be decided by imageology, clinical examination as well as plasma MMP-9 level. MMP-9 can be regarded as latent serum marker of vulnerable plaque, and has clinical significance in synteresis, diagnosis, and therapy of ischemic cerebrovascular disease.