急性脑梗死患者颈动脉硬化与血清LTB4、MMP—9表达水平的相关性研究(1)
[摘要] 目的 探讨急性脑梗死患者颈动脉硬化与血清白三烯B4(LTB4)、基质金属蛋白酶-9(MMP-9)表达水平的相关性。 方法 选取2014年1月～2016年1月于湖州市中心医院神经内科接受治疗的200例确诊急性脑梗死患者，根据是否存在颈动脉硬化分为颈动脉硬化组(143例)和对照组(57例)；再根据内膜增厚程度，将颈动脉硬化组分为内膜增厚组(22例)、斑块组(67例)和颈动脉狭窄组(54例)。比较各组间血清LTB4、MMP-9浓度的差异。 结果 血清LTB4、MMP-9在颈动脉硬化组中的表达水平明显高于对照组，差异有统计学意义(P < 0.05)。在颈动脉狭窄组中血清LTB4、MMP-9的表达高于颈动脉斑块组及内膜增厚组，差异有统计学意义(P < 0.05)；颈动脉斑块组LTB4、MMP-9表达水平高于内膜增厚组，差异有统计学意义(P < 0.05)；且Spearman相关检验提示血清LTB4、MMP-9表达水平与颈动脉硬化严重程度呈正相关(P < 0.05)。 结论 急性脑梗死患者中颈动脉硬化及其程度与血清LTB4、MMP-9表达水平有关。
[关键词] 血清白三烯B4；基质金属蛋白酶-9；颈动脉硬化
[中图分类号] R74 [文献标识码] A [文章编号] 1673-7210(2017)08(b)-0052-04
[Abstract] Objective To study the relationship between serum levels of leukotriene B4 (LTB4)， matrix metallopeptidase 9 (MMP-9) and the degree of arteriosclerosis in the patients with acute cerebral infarction. Methods From January 2014 to January 2016， 200 patients with acute cerebral infarction were selected. They were divided into carotid atherosclerosis group (143 cases) and control group (57 cases)， according to whether there exist carotid atherosclerosis. Then， the patients in the carotid atherosclerosis group were divided into intima thickening group (22 cases)， plaque group (67 cases) and carotid artery stenosis group (54 cades)， according to the degree of intimal thickening. The levels of serum LTB4， MMP-9 in the groups were compared. Results The levels of serum LTB4， MMP-9 in the carotid atherosclerosis group were obviously higher than those in the control group， with statistically significant difference (P < 0.05). The expression in the carotid artery stenosis group was significantly higher than that in the carotid plaque group and intima thickening group， and Spearman correlation test showed the levels of LTB4 and the MMP-9 were positively related to severity of carotid atherosclerosis (P < 0.05). Conclusion The levels of serum LTB4 and MMP-9 are positively correlated with the carotid atherosclerosis and the degree in patients with acute cerebral infarction.
[Key words] Leukotriene B4； Matrix metallopeptidase 9； Carotid arteriosclerosis
白三烯B4(1eukotriene B4，LTB4)是花生四烯酸(arachidonicacid，AA)的代謝产物之一。早期研究已经表明LTB4可以上调斑块内基质金属蛋白酶(matrix metallopeptidase，MMPs)表达。MMP-9为诸多基质金属蛋白酶因子中的最重要一种，通过降解血管基底膜及斑块纤维帽的主要成分，破坏血管基底膜及斑块纤维帽，造成血管基底膜的通透性增高、渗出增加，刺激粥样斑块的不断发展，同时造成斑块纤维帽破裂，最终形成斑块溃疡[1]。多项研究表明，颈动脉斑块的稳定性与急性脑梗死的发生有关，颈动脉易损破裂脱落或血栓形成可能直接导致脑梗死的发生[2-3]。颈动脉硬化导致缺血性脑卒中的机制有动脉-动脉栓塞、血流动力学导致的脑血流低灌注及动脉-动脉栓塞与低灌注共同作用。虽然国内外关于LTB4与冠状动脉粥样硬化及急性冠脉综合征的相关性报道较多，但是涉及LTB4、MMP-9与脑梗死患者颈动脉硬化的相关研究报道罕见。本课题旨在通过对脑梗死伴有颈动脉硬化患者LTB4、MMP-9的表达，对其相关性进行研究。, 百拇医药(马红岗 朱斐斐 王亚仙)
[关键词] 血清白三烯B4；基质金属蛋白酶-9；颈动脉硬化
[中图分类号] R74 [文献标识码] A [文章编号] 1673-7210(2017)08(b)-0052-04
[Abstract] Objective To study the relationship between serum levels of leukotriene B4 (LTB4)， matrix metallopeptidase 9 (MMP-9) and the degree of arteriosclerosis in the patients with acute cerebral infarction. Methods From January 2014 to January 2016， 200 patients with acute cerebral infarction were selected. They were divided into carotid atherosclerosis group (143 cases) and control group (57 cases)， according to whether there exist carotid atherosclerosis. Then， the patients in the carotid atherosclerosis group were divided into intima thickening group (22 cases)， plaque group (67 cases) and carotid artery stenosis group (54 cades)， according to the degree of intimal thickening. The levels of serum LTB4， MMP-9 in the groups were compared. Results The levels of serum LTB4， MMP-9 in the carotid atherosclerosis group were obviously higher than those in the control group， with statistically significant difference (P < 0.05). The expression in the carotid artery stenosis group was significantly higher than that in the carotid plaque group and intima thickening group， and Spearman correlation test showed the levels of LTB4 and the MMP-9 were positively related to severity of carotid atherosclerosis (P < 0.05). Conclusion The levels of serum LTB4 and MMP-9 are positively correlated with the carotid atherosclerosis and the degree in patients with acute cerebral infarction.
[Key words] Leukotriene B4； Matrix metallopeptidase 9； Carotid arteriosclerosis
白三烯B4(1eukotriene B4，LTB4)是花生四烯酸(arachidonicacid，AA)的代謝产物之一。早期研究已经表明LTB4可以上调斑块内基质金属蛋白酶(matrix metallopeptidase，MMPs)表达。MMP-9为诸多基质金属蛋白酶因子中的最重要一种，通过降解血管基底膜及斑块纤维帽的主要成分，破坏血管基底膜及斑块纤维帽，造成血管基底膜的通透性增高、渗出增加，刺激粥样斑块的不断发展，同时造成斑块纤维帽破裂，最终形成斑块溃疡[1]。多项研究表明，颈动脉斑块的稳定性与急性脑梗死的发生有关，颈动脉易损破裂脱落或血栓形成可能直接导致脑梗死的发生[2-3]。颈动脉硬化导致缺血性脑卒中的机制有动脉-动脉栓塞、血流动力学导致的脑血流低灌注及动脉-动脉栓塞与低灌注共同作用。虽然国内外关于LTB4与冠状动脉粥样硬化及急性冠脉综合征的相关性报道较多，但是涉及LTB4、MMP-9与脑梗死患者颈动脉硬化的相关研究报道罕见。本课题旨在通过对脑梗死伴有颈动脉硬化患者LTB4、MMP-9的表达，对其相关性进行研究。, 百拇医药(马红岗 朱斐斐 王亚仙)