脑梗死患者颈动脉斑块与炎性因子的相关性研究

目的探讨炎性因子在颈动脉斑块(CAS)脑梗死患者中的动态变化。方法在急性脑梗死(ACI)患者中根据颈部血管彩超结果分为无斑块组42例,稳定斑块组58例,不稳定斑块组64例,观察在脑梗死急性期(2d)及恢复期(15d)血清中IL-18、ICAM1、MMP-9、Lp-PLA、hsCRP水平变化。结果脑梗死急性期无CAS组、稳定CAS组、不稳定CAS组中血清hsCRP、IL-18、ICAM1、MMP-9、Lp-PLA2水平依次升高,组间比较差异有统计学意义(P0.05),恢复期不稳定斑块组的各炎性因子水平仍高于其他2组(P0.05),无斑块组、稳定斑块组中ICAM1、MMP-9血清水平组间比较差异无统计学意义(P0.05)。结论 hsCRP、IL-18、ICAM1、MMP-9、Lp-PLA2与颈动脉粥样斑稳定性有明显相关性,同时在脑梗死急性期炎性因子hsCRP、IL-18、Lp-PLA2可能参与的炎性作用较ICAM1、MMP-9更为明显。

The study of relationship between carotid atherosclerosis plaque and inflammatory factors in patients with cerebral infarction

Objective To investigate the dynamic changes of inflammatory factors in patients with carotid atherosclerosis plaque and cerebral infarction. Methods According to carotid color Doppler ultrasound divide the patients with acute cerebral infarction (ACI) into no atherosclerosis plaque group (42 cases) ,stable atherosclerosis plaque group 58 cases ,unstable ather‐osclerosis plaque group (64 cases) ,and observed the serum level changes of IL-18 ,ICAM1 ,MMP-9 ,LP-PLA ,hsCRP in the acute stage (2 days) and recovery stage (15 days) in patients with cerebral infarction .Results Serum IL-18 ,ICAM1 , hsCRP ,MMP-9 ,Lp-PLA2 levels of no atherosclerosis plaque group stable atherosclerosis plaque and unstable atherosclerosis plaque group in patients with cerebral infarction increased in turn. Difference between groups was statistically significant (P<0.05) .The levels of inflammatory factors in the unstable plaque group were higher than those in the other two groups in the recovery stage(P<0.05) ,but there was no significant difference between the ICAM1 and MMP-9 in the serum level of the non plaque group and stable plaque group(P>0.05).Conclusion The serum hsCRP ,IL-18 ,ICAM1 ,MMP-9 ,Lp-PLA2 levels were significantly correlated with the stability status of carotid atherosclerotic plaque .At the same time ,hsCRP ,IL-18 ,Lp-PLA2 may be involved in the inflammatory effect is more obvious than MMP-9 ,ICAM1 in the acute phase of cerebral infarc‐tion .