巨细胞病毒感染并发脑卒中颈动脉粥样硬化斑块形成及炎症因子水平

Human cytomegalovirus infection and formation of carotid atherosclerotic plaques and levels of inflammatory factors in stroke patients

目的分析巨细胞病毒(HCMV)感染并发脑卒中颈动脉粥样硬化斑块形成及炎症因子水平。方法选取2017年10月-2019年12月衡水市人民医院神经内科收治的首发脑卒中患者80例为研究对象,并匹配体检中心80名健康人为对照组,利用荧光定量聚合酶链反应(PCR)检测所有受试者外周血中HCMV病毒载量,并分析HCMV感染与颈动脉粥样硬化斑块性质、炎症细胞因子、血管内皮细胞因子水平的相关性。结果脑卒中患者HCMV阳性率33.75%高于对照组(P<0.05);HCMV阳性患者内膜-中膜厚度(IMT)、斑块检出数、不稳定斑块检出率均高于HCMV阴性患者,差异有统计学意义(P<0.05);HCMV阳性患者血清中肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、细胞间黏附分子(ICAM-1)、血管细胞黏附分子(VCAM-1)水平均高于HCMV阴性患者,脂联素、一氧化氮(NO)水平均低于HCMV阴性患者(P<0.05)。结论 HCMV感染与脑卒中患者颈动脉粥样硬化斑块形成有关,并可能是促进炎性损伤,影响脂质代谢及血管内皮功能来促进不稳定斑块发生。

OBJECTIVE To analyze the human cytomegalovirus(HCMV) infection and the formation of carotid arteriosclerosis plaques, levels of inflammatory factors in the stroke patients. METHODS A total of 80 first-attack stroke patients who were treated in Hengshui People’s Hospital from Oct 2017 to Dec 2019 were recruited as the study subjects, 80 healthy people who received physical examination were set as the control group. The peripheral blood HCMV viral load of all the subjects was detected by means of fluorescent quantitative polymerase-chain-reaction(PCR). The correlation between the HCMV infection and the nature of carotid atherosclerotic plaques, inflammatory cytokines and vascular endothelial cytokines was observed. RESULTS The positive rate of HCMV of the stroke patients was significantly higher than that of the control group(P<0.05).The intima-media thickness(IMT), number of detected plaques and detection rate of unstable plaques were significantly higher in the HCMV-positive patients than in the HCMV-negative patients(P<0.05). The levels of serum tumor necrosis factor-α(TNF-α), interleukin-1(IL-1), intercellular adhesion molecule(ICAM-1), vascular cell adhesion molecule(VCAM-1) of the HCMV-positive patients were significantly higher than those of the HCMV-negative patients, and the levels of adiponectin and nitric oxide(NO) of the HCMV-positive patients were significantly lower than those of the HCMV-negative patients(P<0.05). CONCLUSION The HCMV infection is associated with the formation of carotid atherosclerotic plaques, which may promote the development of unstable plaques by promoting inflammatory injury and affecting lipid metabolism and vascular endothelial function.