脑梗死患者血清炎性因子与颈动脉粥样硬化程度的关系

Relationship between serum inflammatory factors and degree of carotid atherosclerosis in patients with cerebral infarction

目的研究脑梗死患者血清细胞间黏附分子1(ICAM-1)、E选择素、L选择素、P选择素和基质金属蛋白酶9(MMP-9)水平与颈动脉粥样硬化程度的关系。方法收集经颈动脉彩色多普勒超声检查证实颈动脉粥样硬化的脑梗死患者130例,按病变程度,将患者分为颈动脉内膜增厚组(19例),颈动脉斑块组(83例)及颈动脉狭窄组(28例)。采用酶联免疫吸附法测定各组血清ICAM-1、E选择素、L选择素、P选择素和MMP-9水平,分析颈动脉硬化程度与血清炎性因子水平的关系。结果①血清ICAM-1、E选择素、P选择素、MMP-9及L选择素在内膜增厚组分别为(344±63)、(11±3)、(23±9)、(1.0±0.3)ng/ml及(294±63)pg/ml;在斑块组分别为(384±71)、(12±4)、(31±11)、(1.1±0.4)ng/ml及(338±110)pg/ml;在狭窄组分别为(503±117)、(13±4)、(32±10)、(1.3±0.5)ng/ml及(394±122)pg/ml,三组比较各指标差异均有统计学意义,P<0.01或P<0.05。②颈动脉粥样硬化程度与血清ICAM-1、E选择素、P选择素、MMP-9及L选择素水平均呈显著正相关(r=0.485,r=0.228,r=0.219,r=0.182,r=0.250;P<0.01或P<0.05)。另外,各炎性因子之间除ICAM-1与E选择素和P选择素外,不同炎性因子水平之间呈正相关。结论脑梗死患者外周血清中炎性因子水平可以在一定程度上反映患者的颈动脉粥样硬化程度。

Objective To study the relationship between the level of inflammatory factors such as intercellular adhesion molecule-1 （ ICAM-1 ）, E-selectin, L-selectin, P-selectin and matrix metalloproteinase-9 （MMP-9） and the degree of carotid atherosclerosis in patients with cerebral infarction. Methods One hundred thirty patients with cerebral infarction confirmed by color Doppler ultrasound examination of carotid artery were collected. The patients were divided into carotid intima thicken group（ n = 19）, carotid plaque group（ n = 83 ） and carotid stenosis group（ n = 28 ） according to the seriousness of the lesion. The levels of serum ICAM-1, E-selectin, L-selectin, P-selectin and MMP-9 in all groups were measured by enzyme-linked immunosorbent assay （ ELISA）, and the relationship between the seriousness of the carotid atherosclerosis and the level of serum inflammatory factors were analyzed. Results ①The levels of serum ICAM-1, E-selectin, P-selectin, MMP-9 and L-selectin in the carotid intima thicken group were 344 ± 63, 11 ± 3, 23 ± 9, 1.0 ± 0. 3 ng/ml and 294 ± 63 pg/ml, respectively, in the carotid plaque group were 384 ±71, 12 ±4, 31 ± 11, 1.1 ±0. 4 ng/ml and 338 ± 110 pg/ml, respectively, and in the carotid stenosis group were 503 ± 117, 13 ± 4, 32 ± 10, 1.3 ± 0.5 ng/ml and 394 ± 122 pg/ml, respectively. There were significant differences among the 3 groups （ P 〈 0. 01 or P 〈 0. 05 ）. ② The seriousness of carotid atherosclerosis was significantly positively correlated with the levels of serum ICAM-1, E-selectin, P-selectin, MMP-9 and L-selectin（r = 0. 485, r = 0. 228, r = 0. 219, r = 0. 182, r = 0. 250; P 〈 0. 01 or P 〈 0. 05）. In addition, there was significant positive correlation between all the inflammatory factors and between the different levels of inflammatory factors except ICAM-1, E-selectin and P-seleetin. Conclusion The levels of inflammatory factors in the peripheral blood in patients with cerebral infarction may reflect the seriousness of carotid atherosclerosis.