不同性质颈动脉粥样斑块患者的血清炎性因子、神经细胞因子的含量变化及相关分析

Change of serum inflammatory factor and nerve cytokine concentrations in patients with different stable carotid atherosclerotic plaques and their correlation analysis

目的:研究不同性质颈动脉粥样斑块患者的血清炎性因子、神经细胞因子的含量及相关性。方法:选择2012年4月~2014年4月期间在我院体检的健康者40例作为健康对照组,经超声检查确诊为颈动脉粥样稳定斑块和不稳定斑块的患者分别作为稳定斑块组(40例)和不稳定斑块组(40例)。检测比较各组血清炎性因子[C反应蛋白(CRP)、基质金属蛋白酶-9(MMP-9)、同型半胱氨酸(Hcy)]、神经细胞因子[脑源性神经营养因子(BDNF)、神经生长因子(NGF)、S100β蛋白、神经元特异性烯醇酶(NSE)]的含量,并分析炎性因子与神经细胞因子含量的相关性。结果:与健康对照组比较,稳定斑块组和不稳定斑块组血清CRP[(1.10±0.14)mg/L比(5.92±0.72)mg/L比(12.46±1.67)mg/L]、MMP-9[(93.48±10.12)μg/L比(234.56±37.72)μg/L比(419.39±55.48)μg/L]、Hcy[(8.39±0.92)μmol/L比(15.48±1.95)μmol/L比(28.61±3.38)μmol/L]、S100β[(0.56±0.07)ng/ml比(0.91±0.10)ng/ml比(1.52±0.19)ng/ml]和NSE[(13.41±1.85)ng/ml比(17.38±2.08)ng/ml比(35.34±4.98)ng/ml]含量均显著升高,BDNF[(8.84±0.92)pg/ml比(7.23±0.91)pg/ml比(3.75±0.49)pg/ml]和NGF[(234.25±34.62)ng/ml比(189.34±22.87)ng/ml比(93.48±10.19)ng/ml]含量均显著减低,且与稳定斑块组比较,不稳定斑块组血清CRP、MMP-9、Hcy、S100β和NSE含量升高更显著,BDNF和NGF含量降低更显著,P<0.05或<0.01。一元线性回归分析显示,血清CRP、MMP-9和Hcy含量与BDNF、NGF含量呈显著负相关(r=-0.810^-0.691,P<0.05或<0.01),与S100β、NSE含量呈显著正相关(r=0.687~0.804,P<0.05或<0.01)。结论:不稳定颈动脉粥样斑块患者血清中炎性因子CRP、MMP-9、Hcy的含量显著升高,并且与神经细胞因子含量存在相关关系。

Objective：To study change of concentrations of serum inflammatory factors and nerve cytokines in patients with different stable carotid atherosclerotic plaques（CAP）and their correlation.Methods：A total of 40 healthy subjects undergoing physical examination were enrolled as healthy control group,patients who were diagnosed as stable CAP and unstable CAP were regarded as stable plaque group（n=40）and unstable plaque group（n=40）.Concentrations of serum inflammatory factors[C reactive protein（CRP）,matrix metalloproteinase-9（MMP-9）,homocysteine（Hcy）]and nerve cytokines [brain-derived neurotrophic factor（BDNF）,nerve growth factor（NGF）,S100βprotein,neuron-specific enolase（NSE）]were measured and compared among all groups,and correlations among inflammatory factor and nerve cytokine concentrations were analyzed.Results：Compared with healthy control group,there were significant rise in serum concentrations of CRP[（1.10±0.14）mg/L vs.（5.92±0.72）mg/L vs.（12.46±1.67）mg/L],MMP-9[（93.48±10.12）μg/L vs.（234.56±37.72）μg/L vs.（419.39±55.48）μg/L],Hcy[（8.39±0.92）μmol/L vs.（15.48±1.95）μmol/L vs.（28.61±3.38）μmol/L],S100β[（0.56±0.07）ng/ml vs.（0.91±0.10）ng/ml vs.（1.52±0.19）ng/ml]and NSE [（13.41±1.85）ng/ml vs.（17.38±2.08）ng/ml vs.（35.34±4.98）ng/ml],and significant reductions in concentrations of BDNF[（8.84±0.92）pg/ml vs.（7.23±0.91）pg/ml vs.（3.75±0.49）pg/ml]and NGF [（234.25±34.62）ng/ml vs.（189.34±22.87）ng/ml vs.（93.48±10.19）ng/ml]in stable plaque group and unstable plaque group,and compared with stable plaque group,there were significant rise in serum concentrations of CRP,MMP-9,Hcy,S100βand NSE,and significant reductions in BDNF and NGF concentrations in unstable plaque group,P〈0.05or0.01.Linear regression analysis indicated that serum concentrations of CRP,MMP-9and Hcy were significant negatively correlated with BDNF and NGF concentrations（r=-0.810--0.691,P〈0.05or0.01）and significant positively correlated with S100βand NSE concentrations（r=0.687-0.804,P〈0.05or0.01）.Conclusion：Serum concentrations of CRP,MMP-9and Hcy significantly rise in patients with unstable CAP,and they are significantly correlated with nerve cytokine concentrations.