急性脑梗死患者颈动脉粥样斑块稳定性与单核细胞趋化因子4、膜联蛋白A1水平的关系

Correlation between stability of carotid atherosclerosis and level of monocyte chemotactic factor 4 and protein annexin A1 in patients with acute cerebral infarction

目的探讨急性脑梗死患者颈动脉粥样斑块稳定性与单核细胞趋化因子4、膜联蛋白A1水平的关系。方法选择西安交通大学医学院神经内科2008年1月至2010年12月住院的124例急性脑梗死患者,男性73例,女性51例,年龄41～88(60.8±12.9)岁,健康对照组35例,其中男性21例,女性14例,年龄42～79(59.3±12.1)岁。采用彩色多普勒超声仪测量颈动脉内中膜厚度及斑块类型,颅脑CT检查计数颅内分布区的梗死病灶。脑梗死患者分为颈动脉正常组(n=26)、稳定型斑块组(n=38)、不稳定型斑块组(n=60)。用酶联免疫法测定单核细胞趋化因子4,用逆转录-聚合酶链反应(RT-PCR)方法检测膜联蛋白A1基因的mRNA表达水平,免疫组化法测膜联蛋白A1的表达,Western blot检测膜联蛋白A1蛋白质表达水平。对检查结果进行比较。结果①颈动脉正常组、稳定型斑块组、不稳定型斑块组的颈内动脉分布区病灶数、颈动脉内中膜厚度差异显著(F=21.36、24.5,P<0.05);②健康对照组、颈动脉正常组、稳定型斑块组和不稳定型斑块组单核细胞趋化因子4的含量比较差异显著(F=19.8,P<0.05);不稳定型斑块组颈动脉粥样斑块组织膜联蛋白A1的mRNA、蛋白表达水平、蛋白表达率明显少于稳定型斑块组(t=2.19、2.876,χ2=9.23,P<0.05)。结论单核细胞趋化因子4、膜联蛋白A1水平与颈动脉粥样斑块不稳定性密切相关,并参与了急性脑梗死的发生。

Objective To study the correlation between the stability of carotid atherosclerosis and levels of monocyte chemotactic factor 4 and protein annexin A1 in patients with acute cerebral infarction.Methods One hundred and twenty-four patients with acute cerebral infarction（73 males and 51 females） at the age of 41-88 years（60.8±12.9 years） admitted to Department of Neurobiology,First Affiliated Hospital,Medical College of Xi＇an Jiaotong University,from January 2008 to December 2010,were enrolled in this study as an experiment group,and 35 healthy individuals（21 males and 14 females） at the age of 42-79 years（59.3±12.1 years） served as a control group.Thickness of carotid intima-media was measured and types of plaque were detected with color Doppler ultrasound.The number of infarctions in brain was calculated by brain CT.Patients with cerebral infarction were further divided into normal carotid group（n=26）,stable plaque group（n=38）,and unstable plaque group（n=60）.Monocyte chemotactic factor 4 level was measured by enzyme-linked immunosorbent assay,and expression levels of A1mRNA,protein,and AI protein were measure by reverse transcription-polymerase chain reaction（RT-PCR）,immunohistochemistry,and Western blotting,respectively and compared.Results The number of brain infarctions,the thickness of intima-media,and the level of monocyte chemotactic factor 4 were significantly higher in stable and unstable plaque groups than in normal group（F=21.36 and 24.5,F=19.8,P0.05）.The expression levels of annexin A1 mRNA and protein were significantly higher in unstable plaque group than in stable plaque group（t=2.19 and 2.876,χ2= 9.23,P0.05）.Conclusion Monocyte chemotactic factor 4 and annexin A1 protein levels are closely related with the instability of carotid plaques and involved in the occurrence of acute cerebral infarction.