急性脑梗死患者血清甲壳质酶蛋白40水平与颈动脉粥样硬化的关系

Relationship between serum levels of enzyme chitin 40 and carotid atherosclerosis in patients with acute cerebral infarction

目的探讨急性脑梗死(ACI)患者血清甲壳质酶蛋白40(YKL-40)水平与颈动脉粥样硬化的关系。方法采用酶联免疫吸附(ELISA)法对78例ACI患者(ACI组)和34名健康体检者(正常对照组,NC组)进行血清YKL-40水平检测;并对ACI患者采用彩色多普勒超声仪进行颈动脉超声检查,测定其颈动脉内膜-中层厚度(IMT)及颈动脉粥样硬化斑块的性质。结果 ACI组患者血清YKL-40水平明显高于NC组(P<0.001)。共有74例(94.9%)ACI患者存在颈动脉IMT异常。其中,管腔狭窄组(颈动脉IMT>1.4 mm)的血清YKL-40水平明显高于斑块形成组(IMT 1.2～1.4 mm)及内膜增厚组(IMT 1.0～1.1 mm)(均P<0.05);而斑块形成组与内膜增厚组比较差异无统计学意义。有64例患者(82.1%)存在颈动脉粥样硬化斑块(不稳定斑块40例,稳定斑块24例),12例患者(15.4%)表现为颈动脉内膜粗糙。其中,不稳定斑块组血清YKL-40水平明显高于稳定斑块组和内膜粗糙组(均P<0.01);而稳定斑块组与内膜粗糙组的差异无统计学意义。结论 ACI患者血清YKL-40水平明显升高,并且与颈动脉粥样硬化程度有关。

Objective To investigate the relationship between serum levels of enzyme chitin 40 （YKL-40） and carotid atherosclerosis in patients with acute cerebral infarction （ACI）. Methods The serum levels of YKL-40 in 78 ACI patients （ACI group ） and 34 healthy controls （normal control group, NC group ） were detected by enzymelinked immunosorbent assay （ELISA）. The ACI patients were examined by carotid uhrasonography to discover the thickness of carotid artery intima-media （IMT） and the characteristic of atherosclerosis plaque. Results The serum level of YKL-40 in ACI group was significantly higher than that in NC group （ P 〈 0. 001 ）. There were 74 ACI patients （94.9%） with increased carotid artery IMT. In which, the serum level of YKL-40 in stenosis group （ carotid artery IMT 〉 1.4 mm） was significantly higher than that in plaque group （ IMT 1.2 - 1.4 mm） and intima thickened group （ IMT 1.0 - 1.1 mm） （ all P 〈 0. 05） ; while there was no significant difference of the serum level of YKL-40 between plaque group and intima thickened group. There were 64 ACI patients （82. 1% ） with carotid plaques （including unstable plaques 40 cases and stable plaques 24 cases） and 12 ACI patients （15.4%） with carotid intima rough. In which, the serum level of YKL-40 in unstable plaque group was significantly higher than that in stable plaque group and intima rough group （all P 〈0. 01 ） ; while there was no significant difference of the serum level of YKL-40 between stable plaque group and intima rough group. Conclusion The serum level of YKL-40 in ACI patients is increased and also closely related to the carotid atherosclerosis.