摘要
目的探讨颈动脉支架置入(CAS)后炎症因子及其与术后新发缺血性损伤的关系。方法 42例(共48条)颈动脉严重狭窄患者,施行CAS前后分别检测主动脉根部血样(全身血)与颈动脉粥样斑块处血(局部血)白介素-6(IL-6)、IL-18、基质金属蛋白酶(MMP-2)及MMP组织抑制因子(TIMP-1)水平,术后行MRI扫描检查有无大脑缺血性损伤。结果 CAS术后,局部血样IL-6水平为1.84～6.78 pg/ml,明显高于全身血样的1.02～3.41 pg/ml(P<0.01),局部血样与全身血样中的IL-18、TIMP-1、MMP-2水平比较,差异均无统计学意义(P>0.05)。19例症状性狭窄患者局部血IL-6水平为4.6(2.7～11.2)pg/ml,明显高于全身样本的2.4(1.1～5.5)pg/ml(P<0.01)。局部IL-6高水平与新发缺血性血管损伤密切相关(P=0.02)。结论由粥样斑块释放的IL-6极有可能是CAS术后并发症发生的重要因子。
Objective To explore the relationship between inflammatory factors and new ischemic injury in the patients undertook carotid artery stenting（CAS） after operation. Methods Forty two patients with severe carotid stenosis（48 arteries） undertook CAS. Blood samples were obtained from the root of aorta （whole-body blood） and earotid plaque site （ local blood） before and after operation, and to detect the levels of interleukin-6 （IL-6）, interleukin-18 （IL-18） ,matrix metalloproteinase-2（MMP-2） ,tissue inhibitor of MMP-1 （TIMP-1）, MRI was performed in the patients after operation to determine whether they had the new eerebral ischemie lesions or not. Results After CAS,IL-6 level of local blood samples ranged from 1.84 pg/ml to 6. 78 pg/ml, which was significantly higher than that of whole-body blood samples （ranged from 1.02 pg/ml to 3.41 pg/ml,P 〈0. 01 ）,there was no significant difference in the levels of IL-18,TIMP-1 ,MMP-2 between local blood samples and whole-bedy blood samples （P 〉 0. 05）. IL-6 levels of local blood samples of 19 patients with symptomatic stenosis lesions were significantly higher than that of whole-body blood samples [ 4.6 （ 2.7 - 11.2） pg/ml vs 2.4（ 1.1 -5.5 ）pg/ml,P 〈 0.01 ]. Increased local IL-6 levels had a significant association with new ischemie injury （P = 0.02）. Conclusion IL-6 released from plaque might be the important factor of the occurrence of periproeedural eomplieations associated to CAS.
出处
《广西医学》
CAS
2012年第12期1641-1643,1651,共4页
Guangxi Medical Journal
基金
广西贵港市科学研究与技术开发项目(贵科攻0908007)
