脑白质疏松患者颈动脉斑块稳定性与血清基质金属蛋白酶2及9的关系

Relationship between Stability of Carotid Plaque in Patients with Leukoaraiosis and MMP-2,MMP-9 in Serum of the Patients

目的:探讨不同类型脑白质疏松(LA)患者颈动脉斑块稳定性及其与基质金属蛋白酶2(MMP-2)和基质金属蛋白酶9(MMP-9)水平的关系。方法:将入组的LA患者根据头颅MRI表现分为脑室周围型组,皮质下型组和混合型组。应用颈动脉彩超检测其颈动脉斑块并分为稳定性和不稳定性斑块,计算斑块积分。ELISA法检测MMP-2及MMP-9水平。结果:①皮质下型组和混合型组斑块阳性率及不稳定颈动脉斑块积分均较脑室周围型组显著增高(P<0.05);②皮质下型组和混合型组的MMP-2、MMP-9水平与脑室周围型组相比差异均有显著统计学意义(P<0.01);③3组LA患者的MMP-9水平与不稳定斑块积分均呈正相关。结论:皮质下型和混合型组LA患者的颈动脉斑块阳性率及斑块不稳定性均较脑室周围型高;皮质下型组的MMP-2和MMP-9水平与脑室周围型组比存在差异;MMP-9水平与不稳定斑块积分呈正相关,提示皮质下型LA与颈动脉斑块存在一定相关性。

Aim： To explore the relationship between the stability of carotid atherosclerosis in different types of Ieukoaraiosis（LA） patients and the concentration of matrix metalloproteinase 2（MMP-2） and matrix metalloproteinase 9（MMP-9）. Methods： All LA patients enrolled were divided into 3 groups according to their brain MRI（periventricular type group, subcortical type group and mixed type group）. The carotid artery plaques were detected by carotid artery ultrasonography and were divided into stable palques and vulnerable plaques by their ultrasonographic images. Plaque score was calculated with crouses method. The blood concentration of MMP-2 and MMP-9 were assayed by ELISA. Results：（1） In all three groups, the positive rates of carotid artery plaques of subcortical type group and mixed type group were both absolutely higher than those of periventricular type group （P〈0.05）. There were no difference in all the stable plaque scores of the three groups.While the vulnerable plaque scores in subcortical type group and mixed type group were both statistically higher than those in periventricular type group（P〈0.05）. （2） There were marked difference of concentration of MMP- 2 and MMP-9 between subcortical type group and periventricular type group as well as between mixed group Ⅲ and periventricular type（P〈0.01）. No difference appeared between subcortical type group and mixed type group Ⅲ. （3） The concentration of MMP-9 in three groups were all positively corelated to the scores of their vulnerable plaque（r=0.49, 0.27, 0.40, P〈0.01, P〈0.05, P〈0.01）. While there was no relationship between MMP-2 concentration and vulnerable plaque scores （P〉0.05）. Conclusion： The positive rates and vulnerability of carotid plaques in LA patients of subcortical type and mixed type were both higher than those in circumventricular type. Concentration of MMP-2 and MMP-9 both showed differences between subcortical type and circumventricular type LA subgroup. The MMP-9 level was positively related to vulnerable plaque scores, which indicated that MMP-9 maybe a potential serum biomarker of vulnerable plaques.