脂联素、肿瘤坏死因子-α、白介素一6与人颈动脉粥样硬化斑块关系的研究

Relations of human carotid atherosclerotic plaque with levels of adiponectin, tumor necrosis factor-or and interleukin-6

目的探讨脂联素（APN）、肿瘤坏死因子-α（TNF．仪）、白介素一6（IL．6）与人颈动脉粥样硬化斑块形成及稳定性的关系。方法选取郑州大学第五附属医院血管外科自2011年4月至2012年7月行颈动脉内膜剥脱术患者48例作为颈动脉粥样硬化斑块组，并依据术前颈动脉CTA检查结果分为软斑组（n=16）、混合斑组（n=16）和硬斑组（n=16）；选取普通外科因外伤手术切除的25例肠系膜上动脉标本作为标本对照组；选取同期体检健康者25例作为健康对照组。采用酶联免疫吸附法（ELISA法1测定颈动脉粥样硬化斑块组和健康对照组血清TNF-α、IL．6含量，应用反转录一聚合酶链反应（RT—PCRl和Westernblotting方法分别检测颈动脉粥样硬化斑块组和标本对照组APNmRNA和蛋白表达水平。结果与健康对照组相比，软斑组、混合斑组、硬斑组血清TNF-α、IL一6含量均明显增高，差异有统计学意义（P〈0．05）；且软斑组TNF-α、IL．6含量明显高于硬斑组，差异有统计学意义（P〈0．05）。与标本对照组相比，软斑组、混合斑组、硬斑组APNmRNA及蛋白表达均明显下调，差异有统计学意义（P〈0．05）；且软斑组APNmRNA及蛋白表达水平明显低于硬斑组，差异有统计学意义俨〈0．05）。颈动脉粥样硬化斑块组血清TNF一仪与IL一6含量呈正相关关系（r=0．810，P=0．000），血清TNF-α、IL-6含量分别与APN蛋白表达水平呈负相关关系（F一0．760，P=-0．000；F一0．519．p=-0．007）。结论APN、TNF-α、IL．6可能参与了人颈动脉粥样硬化斑块的形成及稳定。

Objective To investigate the correlation between levels of adiponectin （APN） and tumor necrosis factor-u （TNF-c0 and interleukin-6 （IL-6） and both formation and stability of human carotid atherosclerotic plaques. Methods Forty-eight specimens from patients with carotid atherosclerotic plaques （carotid plaque group）, admitted to our hospital from April 2011 to July 2012 and performed carotid endarterectomy, and 25 specimens from patients with superior mesenteric artery and 25 healthy subjects （specimen control group and healthy control group ,respectively） were collected in our study. The carotid atherosclerotic plaque specimens were sub-divided into soft plaque group （n=16）, mixed plaque group （n=16） and hard plaque group （n=16） according to the results ofCT angiography （CTA）. The serum TNF-oL and IL-6 levels in the carotid plaque group and the healthy control group were measured by enzyme linked immunosorbent assay （ELISA）, and the mRNA and protein expressions of APN in the carotid plaque group and the specimen control group were determined by reverse transcription-polymerase chain reaction（RT-PCR） and Western blotting. Results The levels of serum TNF-u and IL-6 in all patients with carotid atherosclerotic plaques were significantly increased ascompared with those in the healthy control group （P〈0.05）; those in soft plaque group was significantly higher than those in the hard plaque group （P〈0.05）. The mRNA and protein expressions of APN in all patients with carotid atherosclerotic plaque were significantly decreased as compared with those in specimen control group （P〈0.05）; soft plaque group exhibited lower mRNA and protein expressions of APN than hard plaque group （P〈0.05）; there was a positive correlation between the serum TNF-c and IL-6 levels in the carotid plaque group （r=0.810, /--0.000）; there was negative correlation between the levels of serum TNF-x and IL-6 and the protein expression of APN in the carotid plaque group （r= -0.760, P=-0.000; r=-0.519, P=-0.007, respectively）. Conclusion APN, TNF-c and 1L-6 are likely to participate in the formation and stability of human carotid atherosclerotic plaques.