缺血性脑卒中患者血清基质金属蛋白酶-9、超敏C反应蛋白水平与颈动脉粥样硬化的相关性

Relationship between levels of serum MMP-9,hs-CRP and carotid atherosclerosis in ischemic stroke

目的探讨急性缺血性脑卒中患者血清基质金属蛋白酶-9(MMP-9)、超敏C反应蛋白(hs-CRP)水平与颈动脉粥样硬化的关系。方法选择发病72 h内的急性前循环缺血性脑卒中患者120例为观察组,应用彩色多普勒超声检查颈动脉粥样硬化斑块;应用酶联免疫法(ELISA)测定血清MMP-9、hs-CRP浓度,同时选取门诊健康体检者72例作为健康对照组。观察组根据颈动脉斑块的性质分为不稳定斑块亚组(39例)、稳定斑块亚组(51例)及无斑块亚组(30例),将有斑块患者根据颈动脉狭窄程度分为轻度狭窄亚组(28例)、中度狭窄亚组(45例)、重度狭窄亚组(17例),比较各组间血清MMP-9、hs-CRP浓度的差异。结果缺血性卒中患者MMP-9、hs-CRP水平较健康对照组明显升高(分别为t=11.716,t=10.759,P均<0.01)。随着颈动脉斑块不稳定性增加,MMP-9、hs-CRP水平升高(P均<0.01);随着颈动脉狭窄程度加重,MMP-9、hs-CRP水平也升高(P均<0.01);且缺血性卒中患者急性期血清MMP-9与hs-CRP呈显著正相关(r=0.855,P<0.01)。结论 MMP-9、hsCRP参与了急性缺血性脑卒中的发病过程,颈动脉粥样硬化严重程度不同的缺血性脑卒中患者血清MMP-9、hs-CRP水平存在差异,MMP-9和hs-CRP可能是不稳定性斑块及缺血性脑卒中的一个潜在血清标志物。

Objective To investigate the relationship among serum matrix metalloproteinase-9 （MMP-9）, high sensi-tive C reactive protein （ hs-CRP） level and carotid atherosclerosis in acute cerebral ischemic patients.Methods One hundred and twenty cases of onset within 72 h acute anterior circulation ischemic stroke were enrolled as the observation group , ultra-sound examination of carotid atherosclerotic plaque by color Doppler were performed ;using enzyme linked immunosorbent as-say （ ELISA） to determine the serum MMP-9, hs-CRP concentrations , and selected 72 healthy patient as healthy control grou.According to the property of carotid plaque , the observation group is divided into unstable plaque sub group （39 ca-ses）, stable plaque sub group （51 cases） and non-plaque sub group （30 cases）, according to the degree of carotid artery ste-nosis, they were divided into mild narrow sub group （28 cases）, moderate stenosis sub group （45 cases） and severe narrow sub group （17 cases）, the difference of serum MMP-9, hs-CRP concentrations were compared among these groups.Results The ischemic stroke patients’ MMP-9, hs-CRP were higher than the healthy control group （ t =1.716, t =1.759, respec-tively, P 〈0.01.With the increase of carotid artery plaque instability , MMP-9, hs-CRP levels were increased （ P 〈0.01）;along with the degree of carotid artery stenosis aggravates , MMP-9, hs-CRP levels were also elevated （ P 〈0.01）;and the acute phase of ischemic stroke patients ’ serum MMP-9 were positive correlated with hs-CRP （ r =0.855, P 〈0.01.Conclusion MMP-9 and hs-CRP are involved in the pathogenesis of acute ischemic stroke , different carotid athero-sclerosis severity related to different serum MMP 9 and hs-CRP level , MMP-9 and hs-CRP may be a potential biomarker for in-stabilities of plaque and ischemic stroke.