CAJ | 학술논문

目的探讨基质金属蛋白酶(MMP-2)及其抑制剂金属蛋白酶组织抑制因子(TIMP-2)与颈动脉粥样硬化斑块易损性的关系. 方法对60例首次前循环型动脉粥样硬化性脑梗死恢复期患者及38名同期门诊体检正常者(无斑块组)行颈动脉超声检查,分别测定颈动脉内中膜厚度(IMT)、Crouse积分(CPI)、斑块总面积(CPA).根据超声病理形态将患者分为易损斑块组(33例)和稳定斑块组(27例).ELISA法测定血清MMP-2、TIMP-2水平. 结果易损斑块组颈动脉IMT、CPI、CPA均大于稳定斑块组及无斑块组;稳定斑块组颈动脉IMT、CPI、CPA均大于无斑块组,差异均有统计学意义(P<0.05).易损斑块组血清MMP-2、MMP-2/TIMP-2比值均高于稳定斑块组及无斑块组,TIMP-2低于稳定斑块组及无斑块组,差异均有统计学意义(P<0.05).易损斑块组血清MMP-2、MMP-2/TIMP-2比值与IMT、CPI、CPA均呈正相关(r=0.961,r=0.966,r=0.804;r=0.625,r=0.709,r=0.651;P均<0.05).易损斑块组血清TIMP-2与IMT、CPI、CPA均呈负相关(r=0.944,r=-0.996,r=-0.859,P均<0.05).稳定斑块组血清MMP-2、MMP-2/TIMP-2比值与IMT、CPI、CPA均呈正相关(r=0.429,r=0.461,r=0.423;r=0.601,r=0.673,r=0.571;P均<0.05).易损斑块组血清TIMP-2与IMT、CPI、CPA均呈负相关(r=-0.507,r=-0.568,r=-0.554,P均<0.05). 结论血清MMP-2、TIMP-2水平及MMP-2/TIMP-2比值与颈动脉粥样硬化斑块易损性密切相关.
목적 탐토기질금속단백매(MMP-2)급기억제제금속단백매조직억제인자(TIMP-2)여경동맥죽양경화반괴역손성적관계. 방법 대60례수차전순배형동맥죽양경화성뇌경사회복기환자급38명동기문진체검정상자(무반괴조)행경동맥초성검사,분별측정경동맥내중막후도(IMT)、Crouse적분(CPI)、반괴총면적(CPA).근거초성병리형태장환자분위역손반괴조(33례)화은정반괴조(27례).ELISA법측정혈청MMP-2、TIMP-2수평. 결과 역손반괴조경동맥IMT、CPI、CPA균대우은정반괴조급무반괴조;은정반괴조경동맥IMT、CPI、CPA균대우무반괴조,차이균유통계학의의(P<0.05).역손반괴조혈청MMP-2、MMP-2/TIMP-2비치균고우은정반괴조급무반괴조,TIMP-2저우은정반괴조급무반괴조,차이균유통계학의의(P<0.05).역손반괴조혈청MMP-2、MMP-2/TIMP-2비치여IMT、CPI、CPA균정정상관(r=0.961,r=0.966,r=0.804;r=0.625,r=0.709,r=0.651;P균<0.05).역손반괴조혈청TIMP-2여IMT、CPI、CPA균정부상관(r=0.944,r=-0.996,r=-0.859,P균<0.05).은정반괴조혈청MMP-2、MMP-2/TIMP-2비치여IMT、CPI、CPA균정정상관(r=0.429,r=0.461,r=0.423;r=0.601,r=0.673,r=0.571;P균<0.05).역손반괴조혈청TIMP-2여IMT、CPI、CPA균정부상관(r=-0.507,r=-0.568,r=-0.554,P균<0.05). 결론 혈청MMP-2、TIMP-2수평급MMP-2/TIMP-2비치여경동맥죽양경화반괴역손성밀절상관.
Objective To explore the correlation of serum matrix metalloproteinase-2 (MMP-2) and tissue metalloproteinase inhibitor-2 (TIMP-2) levels to carotid atherosclerosis plaque vulnerability in patients with anterior circulation infarction. Methods Sixty patients with anterior circulation infarction and 38 healthy volunteers were enrolled in this study. Color Doppler ultrasonography of the carotid artery was performed to determine the carotid intima-media thickness (IMT), Crouse plaque integral (CPI) score, and the total carotid plaque area (CPA). According to the nature of the carotid atherosclerosis plaque defined by ultrasonography, the patients were divided into vulnerable plaque (VP) group (33 cases), stable plaque (SP) group (27 cases), and no plaque (NP) group (38 cases). Serum MMP-2 and TIMP-2 levels were detected in these subjects using enzyme-linked immnosorbent assay (ELISA). Results Ultrasonography showed significantly greater/MT, CPI and CPA in VP group than in SP and NP groups (P<0.05). Serum MMP-2 level was significantly elevated in VP group as compared with that in SP and NP groups (P<0.05). Serum TIMP-2 level was significantly lower in VP group than in SP and NP groups (P<0.05). In VP group, serum MMP-2 level and MMP-2/TIMP-2 ratio were found to positively correlate to IMT, CPl and CPA (r=0.961, 0.966, and 0.804 for MMP-2, respectively, P<0.05;r=0.625, 0.709, and 0.651 for MMP-2/TIMP-2 ratio, respectively, P<0.05), while TIMP-2 was inversely correlated to IMT, CPI and CPA (r=-0.944, -0.996, and -0.859, respectively, P<0.05). Conclusion Serum MMP-2 and TIMP-2 levels and MMP-2/TIMP-2 ratio are closely correlated to carotid atherosclerosis plaque vulnerability.