急性脑梗死并发人巨细胞病毒感染脑脊液Acrp30、MMP-3、sIL-2R表达及意义

Expressions of Acrp30,MMP-3 and sIL-2R in cerebrospinal fluid in acute cerebral infarction patients with human cytomegalovirus infection and their significance

目的分析急性脑梗死(ACI)并发人巨细胞病毒感染(HCMV)患者脑脊液脂肪细胞补体相关蛋白(Acrp30)、基质金属蛋白酶3(MMP-3)和可溶性白细胞介素-2受体(sIL-2R)表达及意义。方法选择2016年1月-2021年7月徐州医科大学附属宿迁医院收治的ACI患者201例为研究对象,依据血清HCMV免疫球蛋白G(HCMV-IgG)结果分为感染组79例和无感染组122例,比较感染组和无感染组患者一般资料和脑脊液检查指标(Acrp30、MMP-3、sIL-2R)水平,分析ACI患者出现HCMV感染因素;比较上述指标与脑血管病变的关系。结果感染组患者年龄高于无感染组(P<0.05),脑脊液Acrp30低于无感染组,MMP-3、sIL-2R和HCMV-IgG均较无感染组升高(P<0.05)。多因素Logistic回归分析结果显示,脑脊液Acrp30降低,MMP-3和sIL-2R水平升高是ACI患者HCMV感染的危险因素(P<0.05)。感染组脑血管不同病变程度患者比较,中度患者脑脊液Acrp30低于轻度,MMP-3、sIL-2R水平高于轻度(P<0.05);重度患者Acrp30低于轻、中度,MMP-3、sIL-2R水平高于轻、中度(P<0.05)。结论Acrp30表达降低和MMP-3和sIL-2R水平升高是ACI合并HCMV感染的危险因素,HCMV感染的ACI患者通过下调Acrp30,增加MMP-3和sIL-2R表达,加速血管内皮损伤的进程,加剧脑血管病变进展。

OBJECTIVE To investigate the expressions of adipocyte complement-related protein of 30kD(Acrp30),matrix metalloproteinase 3(MMP-3)and soluble interleukin-2 receptor(sIL-2R)in cerebrospinal fluid of acute cerebral infarction(ACI)patients with human cytomegalovirus(HCMV)infection and analyze the significance.METHODS A total of 201 ACI patients who were treated in Suqian Hospital Affiliated to Xuzhou Medical University from Jan 2016 to Jul 2021 were recruited as the study subjects and divided into the infection group with 79 cases and the no infection group with 122 cases according to the result of serum HCMV immunoglobin G(HCMV-IgG)test.The baseline data and levels of cerebrospinal fluid indexes(Acrp30,MMP-3,sIL-2R)were compared between the infection group and the no infection group,the risk factors for HCMV infection in the ACI patients were analyzed,and the relationship between the above indexes and the cerebrovascular lesions was observed.RESULTS The patients of the infection group were older than those of the no infection group(P<0.05).The cerebrospinal fluid Acrp30 level of the infection group was lower than that of the no infection group,the levels of MMP-3,sIL-2R and HCMV-IgG of the infection group were higher than those of the no infection group(P<0.05).The result of multivariate logistic regression analysis showed that the decline of cerebrospinal fluid Acrp30 and the rise of MMP-3 and sIL-2R were the risk factors for the HCMV infection in the ACI patients(P<0.05).In the infection group,the cerebrospinal fluid Acrp30 level of the patients with moderate cerebrovascular lesions was lower than that of the patients with mild lesions,while the levels of MMP-3 and sIL-2R of the patients with moderate lesions were higher than that of the mild lesions(P<0.05);the Acrp30 level of the patients with severe lesions was lower than that of the patients with mild and moderate lesions,while the levels of MMP-3 and sIL-2R of the patients with severe lesions were higher than those of the patients with mild,moderate lesions(P<0.05).CONCLUSION The decline of Acrp30 and rise of MMP-3 and sIL-2R are the risk factors for HCMV infection in the ACI patients.The down-regulation of Acrp30 and upregulation of MMP-3 and sIL-2R may accelerate the process of vascular endothelial injury and aggravate the progression of cerebrovascular lesions.