基质金属蛋白酶9及其组织型抑制剂1水平与老年脑梗死患者颈动脉粥样硬化程度的关系

Relation of matrix metalloproteinase-9 and its inhibitor with carotid artery atherosclerosis in aged patients with cerebral infarction

目的:探讨基质金属蛋白酶9(metalloproteinase-9,MMP-9)及组织基质金属蛋白酶抑制剂1(tissue inhibitor ofmetalloproteinase-1,TIMP-1)与老年脑梗死患者颈动脉粥样硬化程度的相关性。方法:选择老年脑梗死患者260例,应用高分辨超声测量颈动脉内膜中层厚度(intimated thickness,IMT)及斑块情况。患者分为4组:IMT正常组(24例)、IMT增厚组(62例)、稳定性斑块组(110例)和不稳定性斑块组(64例)。测定血清生化指标、MMP-9、TIMP-1水平并行组间比较。结果:IMT正常组、IMT增厚组、稳定性斑块组和不稳定性斑块组血清MMP-9、TIMP-1水平依次增高,不稳定性斑块组MMP-9/TIMP-1比值明显高于其他3组(P<0.01)。以颈动脉是否存在斑块为因变量,与其相关的因素为自变量,Logistic回归分析显示,颈动脉斑块形成与体质指数(body mass index,BMI)、收缩压、甘油三酯(triglycerides,TG)、lgMMP-9呈正相关。以颈动脉斑块稳定性为因变量,与其相关的因素为自变量,Logistic回归分析显示,颈动脉斑块的稳定性与BMI、TG、lgMMP-9呈正相关。结论:老年脑梗死患者血清MMP-9水平、TIMP-1水平与颈动脉斑块及其稳定性密切相关。

Objective：To study the relation of serum matrix metalloproteinase-9（MMP-9） and tissue inhibitor of metalloproteinase-1（TIMP-1） with carotid artery atherosclerosis in elderly patients with cerebral infarction.Methods：Two hundred and sixty patients with cerebral infarction were divided into normal intimated thickness（IMT） group（n = 24）,increased IMT group（n = 62）,stable plaque group（n = 110） and unstable plaque group（n = 64）.Their IMT and carotid plaques were detected by high resolution B mode ultrasonography.And their serum levels of biochemical indicators,MMP-9 and TIMP-1,were measured and compared.Results：The serum MMP-9 and TIMP-1 levels increased gradually in the 4 groups and were higher in the unstable plaque group than in the other three groups（P〈 0.01）.Logistic regression analysis showed that the arotid artery atherosclerosis was positively correlated with the body mass index（BMI）,systolic blood pressure（SBP）,triglycerides（TG）,and lgMMP-9 of patients with cerebral infarction.And the stability of carotid plaque was positively correlated with the BMI,TG and lgMMP-9.Conclusion：Serum MMP-9 and TIMP-1 levels are closely related with stability of carotid plaque in aged patients with cerebral infarction.