摘要
目的探讨炎性指标和颈动脉粥样斑块稳定性与急性脑梗死的关系。方法对71例急性脑梗死患者(A组)、44例无症状颈动脉硬化患者(B组)和21名健康对照者(C 组)进行研究,彩色多普勒超声仪测量颈动脉内中膜厚度(IMT)、斑块类型,酶联免疫法测定可溶性血管细胞黏附分子-1(sVCAM-1)、可溶性 E-选择素(sE-选择素)、可溶性 CD_(40)配体(sCD_(40)L)、单核细胞趋化因子-1(MCP-1)含量。结果 IMT 在 A 组和 B 组比较差异无统计学意义,但与 C 组比较差异有统计学意义;A 组颈动脉斑块以脂质型斑块(59.2%)为主,B 组以纤维型(32.9%)为主;MCP-1、sVCAM-1、sCD_(40)L、sE-选择素含量在 A 组、B 组和 C 组之间差异有统计学意义(均P<0.05)。结论多种细胞因子参与炎症反应是影响颈动脉粥样斑块稳定性的重要原因,在急性脑梗死发病机制中发挥作用。
Objective To explore the correlation of inflammation and destabilization of carotid plaque with acute ischemic stroke. Methods Seventy one patients with acute brain infarction (group A), 44 with asymptomatic carotid atherosclerosis (group B) and 21 normal controls (group C) were investigated. The serum levels of soluble CD40 ligand ( sCD40L), monocyte chemoattractant peptide-1 ( MCP-1 ), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble E-selectin (sE-selectin) were measured by ELISA. Thickness of intima-media (IMT) and carotid plaque echogenicity were evaluated bilaterally by duplex doppler ultrasound. Results The IMT were larger in group A (( 1.11±0. 29 ) mm ) and group B ( ( 1.14±0. 26) mm) as compared to group C ( ( 0. 77±0. 15 ) mm). The distribution of plaque' s echogenicity type was significant different between group A and group B. Fatty plaque (59.2%) was the main type of plaque in group A, fibrous plaque ( 32. 9% ) was frequently seen in group B. There were significant differences among levels of MCP-1, sVCAM-1, sCD4oL and sE-selectin in group A ( (237. 12 ±77.97) pg/ml, ( 1281.33±360. 38) ng/ml, ( 10. 39 ±3. 37) pg/ml, (45.57±9.06) ng/ml) and group B ((168. 18±31.88) pg/ml, (1083.85±219.67) ng/ml, (7.17±2.77) pg/ml and (36.38±11.74) ng/ml) as compared to group C ((84.27±19.02) pg/ml, (545.79±52.05) ng/ml, (2.66 ±1.09) pg/ml, (19. 33±2. 39) ng/ml). Conclusion These results suggest that inflammation participates in the carotid plaque destabilization and plays a key role in the pathogenesis of acute ischemic stroke.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2006年第9期580-582,共3页
Chinese Journal of Neurology
基金
国家自然科学基金(30470702
30570747)
卫生部临床学科重点(20012943
20044661)
关键词
脑梗塞
颈动脉疾病
细胞因子类
Brain infarction
Carotid artery diseases
Cytokines