多种生化标志物与颈动脉粥样硬化斑块稳定性的关系

目的探讨多种生化标志物与颈动脉粥样硬化斑块稳定性的关系。方法选取经颈动脉彩超检查证实为动脉粥样硬化斑块患者78例,根据超声检查结果分为稳定斑块组42例、不稳定斑块组36例;另选择无斑块的健康体检者42例为对照组。分别测定各组血浆C反应蛋白(CRP)、丙二醛(MDA)、白介素-6(IL-6)、可溶性CD40配体(sCD40L)、纤维蛋白原(FIB)及血脂水平。结果不稳定斑块组血浆CRP、IL-6、sCD40L、MDA水平显著高于稳定斑块组及对照组(P均<0.01),稳定斑块组CRP、IL-6、sCD40L水平显著高于对照组(P均<0.01);不稳定斑块组及稳定斑块组的FIB水平显著高于对照组(P均<0.01)。斑块指数与FIB、sCD40L、IL-6、CRP、MDA水平等呈正相关,其中与sCD40L水平相关性较强(r=0.737,P<0.01)。结论血浆生化标志物CRP、IL-6、MDA、sCD40L水平与斑块的不稳定显著相关,IL-6、MDA、sCD40L有望成为评价斑块稳定性及预测斑块破裂较理想的生化标志物。

Correlation between several biomarkers and stability of atherosclerostic plaque

Objective To explore the relationship between plasma biomarkers and stability of carotid atherosclerotic plaque.Methods According to the diagnosis by carotid ultrasonography,120 patients were divided into 3 groups: stable plaque group(42 patients),un-stable plaque group(36 patients) and nonplaque group(42 patients).Plasma levels of C-reactive protein(CRP),Malondialdehyde(MDA),interleu kin-6(IL-6),soluble CD40 ligand(sCD40L),fibrinogen(FIB) and lipid were measured for each patients.Results Plasma levels of CRP,IL-6,sCD40L in the unstable atherosclerotic plaque group were significantly higher than those in the stable plaque group and control group(P<0.01),and the levels of these 3 biomarkers in the stable plaque group were signficantly higher than those in the control group(P<0.01);plasma levels of FIB in the unstable plaques group and stable plaques group were significantly higher than those in the control group(P<0.01),the correlation analysis of Spearsman showed that the grades of plaque index were positively correlated with plasma levels of FIB,sCD40L,IL-6,CRP,MDA.sCD40L was strongly correlated with the grades of plaque index(r=0.737).Conclusions There is a close relatinonship between upregulation of plasma biomarkers of CRP,IL-6,sCD40L levels and unstability of atherosclerotic plaque.The plama levels of IL-6,MDA,sCD40L promise to be the ideal biomarkers which could evaluate stabllity of atherosclerotic plaque and predict the atherosclerotic plaque rupture.