基质金属蛋白酶-3、高敏C-反应蛋白与颈动脉粥样硬化和急性脑梗死的关系

Relationships Between Matrix Metalloproteinase-3,High-sensitivity C-Reactive Protein and Carotid Atherosclerosis and Acute Cerebral Infarction

目的：探讨基质金属蛋白酶-3（MMP-3）、高敏C-反应蛋白（hs—CRP）与颈动脉粥样硬化和急性脑梗死的关系。方法：64例首次发病的脑梗死患者和20例健康体检者，应用酶联免疫双抗体夹心法测定血清MMP-3浓度，免疫散射比浊法测定血清hs—CRP浓度。应用颈动脉超声检测颈动脉内膜状况，并对急性脑梗死患者进行神经功能缺损评分。结果：急性脑梗死患者血清MMP-3和hs—CRP浓度显著高于正常对照组（P〈0．01）。不稳定斑块组（混合斑块组、软斑组）血清MMP-3和hs—CRP浓度显著高于稳定斑块组（硬化斑块组）和内膜毛糙组（P〈0，01）。血清MMP-3和hs—CRP浓度分别与急性脑梗死患者神经功能缺损评分呈正相关。结论：急性脑梗死患者血清MMP-3和hs—CRP水平可以反映颈动脉斑块的性质和稳定性，是临床了解脑梗死严重程度的重要指标。

Objective： To investigate the relationships between matrix metalloproteinase-3 （MMP-3）, high-sensitivity C-reactive protein （hs-CRP） and carotid atherosclerosis and acute cerebral infarction. Methods： Sixty-four patients with the first ever cerebral infarction and 20 normal control subjects were selected. Their serum MMP-3 levels were determined by double antibody enzyme-linked immunosorbent assays, and serum hs-CRP levels were measured by immunonephelometric assay. Their carotid intima-media thicknesses were assessed by carotid ultrasonography, and neurological deficit scores were performed in patients with acute cerebral infarction. Results： The levels of serum MMP-3 and hs-CRP in patients with acute cerebral infarction were significantly higher than those in the normal control group （P 〈 0.01 ）. The levels of serum MMP-3 and hs-CRP in unstable plaque group （mixed plaque group, soft plaque group） were significantly higher than those in stable plaque group （hard plaque group） and rough intima group （P 〈 0. 01 ）. The levels of serum MMP-3 and hs-CRP were positively correlated with the neurological deficit scores respectively in patients with acute cerebral infarction. Conclusions： The levels of serum MMP-3 and hs-CRP in patients with acute cerebral infarction may reflect the character and stability of carotid artery plaque, and they are the important indexes in understanding the severity of cerebral infarction in clinical practice.