血清MMP-9与脑梗死患者及其颈动脉粥样硬化斑块稳定性的关系研究

目的检测具有不同性质颈动脉粥样硬化斑块的脑梗死患者的血清基质金属蛋白酶-9（MMP-9）水平，探讨颈动脉粥样硬化斑块稳定性及相关炎性标志物MMP-9水平与脑梗死的关系。方法采用彩色多普勒超声检查48例颈内动脉系统的急性脑梗死患者（CI组）颈动脉粥样硬化斑块，同时检测患者血清MMP-9水平，并与20例慢性脑供血不足患者（CCCI组）及20例体检健康者（对照组）比较；根据斑块性质将CI组分为不稳定斑块组、稳定斑块组及无斑块组3个亚组，并进行组内比较。结果脑梗死组斑块检出率、不稳定斑块率及血清MMP9水平均明显高于慢性脑供血不足组及对照组（P〈0．05）；脑梗死不稳定斑块组MMP-9水平显著高于脑梗死稳定斑块组，脑梗死稳定斑块组高于脑梗死无斑块组（P〈0．01）。结论颈动脉粥样硬化斑块及其稳定性与脑梗死发生有密切关系，具有不同性质颈动脉斑块的脑梗死患者的血清MMP-9水平存在差异，MMP-9可能是不稳定性粥样硬化斑块及脑梗死的一个潜在的血清标志物。

The Relationship between serum MMP-9 and carotid atherosclerosis and plaque stability in patients with cerebral infarction

Objective To investigate serum matrix metalloproteinase-9 （MMP-9） level in cerebral infarction patients with different characteristic carotid atherosclerotic plaques, and to explore the relationship between carotid atherosclerotic plaque stability and serum MMP-9 level and cerebral infarction. Methods The atherosclerotic plaques in the carotid arteries were assessed by Doppler ultrasonography and serum MMP-9 was detected by enzyme-linked immunosorbent assay in 48 cases of acute cerebral infarction （CI group）, and were compared with 20 cases of chronic cerebral circulation insufficiency （CCCI group） and 20 healthy controls. CI group was divided into three subgroups according to the characteristic of atherosclerosis： no plaque group, stable plaque group and unstable plaque group. Results The rate of plaque and the serum MMP-9 lever in CI group were significantly higher than those of the CCCI group and normal control group （P〈0. 05） ;The serum MMP-9 lever in unstable plaque group was significantly higher than stable plaque group, the later was significantly higher than no plaque group（P〈0. 01）. Conclusions Carotid atherosclerosis and plaque stability are closely related to the formation of cerebral infarction. The serum level of MMP-9 are difference in cerebral infarction patients with different characteristic carotid atherosclerotie plaques. The serum MMP-9 may be a potential serum marker of unstable atherosclerotic plaques and cerebral infarction.