中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
43期
3392-3396
,共5页
钱怡宁%蔺洁%段红霞%罗永挺%冯立群
錢怡寧%藺潔%段紅霞%囉永挺%馮立群
전이저%린길%단홍하%라영정%풍립군
抗原,可溶性CD146%颈动脉粥样硬化%斑块易损性
抗原,可溶性CD146%頸動脈粥樣硬化%斑塊易損性
항원,가용성CD146%경동맥죽양경화%반괴역손성
Antigens,soluble CD146%Carotid atherosclerosis%Plaque vulnerability
目的 探讨血清可溶性CD146(sCD146)水平与颈动脉粥样硬化(CAS)斑块易损性的关系.方法 2011年3月至2012年9月从北京安贞医院血管外科入选40例症状性颈动脉狭窄(≥70％)患者,根据超声影像结果分为稳定斑块组(16例)和不稳定斑块组(24例).在体检中心入选40名健康者为对照组.测定所有研究对象的sCD146水平及CAS患者的超敏C反应蛋白(hs-CRP)、金属基质蛋白酶-9(MMP-9)水平,分析sCD146与炎症反应因子的相关性,探讨sCD146与CAS斑块易损性的关系.结果 CAS患者血清sCD146水平明显高于健康对照者[(212 ±43) ng/ml比(173±36) ng/ml,P＜0.001],斑块不稳定组sCD146水平明显高于斑块稳定组[(218±28)ng/ml比(176±25) ng/ml,P＜0.000 1],斑块稳定组与正常对照组sCD146水平无统计学差异[(176±25) ng/ml比(173±36) ng/ml,P=0.639 5].CAS患者的sCD146水平与hs-CRP水平显著正相关(r=0.354 7,P =0.033 8),校正hs-CRP水平,sCD146水平与CAS斑块易损性独立正相关(OR=1.16,95％ CI:1.020～ 1.310,P=0.019 2).CAS患者sCD146水平与动脉粥样硬化危险因素:年龄、同型半胱氨酸水平以及血脂水平无关(P＞0.05).不稳定斑块组sCD146升高明显(P＜0.001),血清MMP-9水平也明显升高[(1 027±293) ng/ml比(649±258) ng/ml,P=0.002 5],二者显著正相关(r=0.677 2,P＜0.001).结论 CAS患者血清sCD146与hs-CRP、MMP-9水平正相关,与斑块的易损性独立正相关,提示炎症反应与斑块内血管新生在CAS的发展过程中可能有相互促进作用.
目的 探討血清可溶性CD146(sCD146)水平與頸動脈粥樣硬化(CAS)斑塊易損性的關繫.方法 2011年3月至2012年9月從北京安貞醫院血管外科入選40例癥狀性頸動脈狹窄(≥70％)患者,根據超聲影像結果分為穩定斑塊組(16例)和不穩定斑塊組(24例).在體檢中心入選40名健康者為對照組.測定所有研究對象的sCD146水平及CAS患者的超敏C反應蛋白(hs-CRP)、金屬基質蛋白酶-9(MMP-9)水平,分析sCD146與炎癥反應因子的相關性,探討sCD146與CAS斑塊易損性的關繫.結果 CAS患者血清sCD146水平明顯高于健康對照者[(212 ±43) ng/ml比(173±36) ng/ml,P＜0.001],斑塊不穩定組sCD146水平明顯高于斑塊穩定組[(218±28)ng/ml比(176±25) ng/ml,P＜0.000 1],斑塊穩定組與正常對照組sCD146水平無統計學差異[(176±25) ng/ml比(173±36) ng/ml,P=0.639 5].CAS患者的sCD146水平與hs-CRP水平顯著正相關(r=0.354 7,P =0.033 8),校正hs-CRP水平,sCD146水平與CAS斑塊易損性獨立正相關(OR=1.16,95％ CI:1.020～ 1.310,P=0.019 2).CAS患者sCD146水平與動脈粥樣硬化危險因素:年齡、同型半胱氨痠水平以及血脂水平無關(P＞0.05).不穩定斑塊組sCD146升高明顯(P＜0.001),血清MMP-9水平也明顯升高[(1 027±293) ng/ml比(649±258) ng/ml,P=0.002 5],二者顯著正相關(r=0.677 2,P＜0.001).結論 CAS患者血清sCD146與hs-CRP、MMP-9水平正相關,與斑塊的易損性獨立正相關,提示炎癥反應與斑塊內血管新生在CAS的髮展過程中可能有相互促進作用.
목적 탐토혈청가용성CD146(sCD146)수평여경동맥죽양경화(CAS)반괴역손성적관계.방법 2011년3월지2012년9월종북경안정의원혈관외과입선40례증상성경동맥협착(≥70％)환자,근거초성영상결과분위은정반괴조(16례)화불은정반괴조(24례).재체검중심입선40명건강자위대조조.측정소유연구대상적sCD146수평급CAS환자적초민C반응단백(hs-CRP)、금속기질단백매-9(MMP-9)수평,분석sCD146여염증반응인자적상관성,탐토sCD146여CAS반괴역손성적관계.결과 CAS환자혈청sCD146수평명현고우건강대조자[(212 ±43) ng/ml비(173±36) ng/ml,P＜0.001],반괴불은정조sCD146수평명현고우반괴은정조[(218±28)ng/ml비(176±25) ng/ml,P＜0.000 1],반괴은정조여정상대조조sCD146수평무통계학차이[(176±25) ng/ml비(173±36) ng/ml,P=0.639 5].CAS환자적sCD146수평여hs-CRP수평현저정상관(r=0.354 7,P =0.033 8),교정hs-CRP수평,sCD146수평여CAS반괴역손성독립정상관(OR=1.16,95％ CI:1.020～ 1.310,P=0.019 2).CAS환자sCD146수평여동맥죽양경화위험인소:년령、동형반광안산수평이급혈지수평무관(P＞0.05).불은정반괴조sCD146승고명현(P＜0.001),혈청MMP-9수평야명현승고[(1 027±293) ng/ml비(649±258) ng/ml,P=0.002 5],이자현저정상관(r=0.677 2,P＜0.001).결론 CAS환자혈청sCD146여hs-CRP、MMP-9수평정상관,여반괴적역손성독립정상관,제시염증반응여반괴내혈관신생재CAS적발전과정중가능유상호촉진작용.
Objective To explore the relationship between circulating level of soluble CD146 (sCD146) and plaque vulnerability or inflammatory factors in patients with carotid atherosclerosis (CAS).Methods Forty CAS patients with carotid stenosis (≥ 70％) were enrolled and divided into 2 groups of stable and unstable plaque by ultrasonic imaging.And another 40 healthy subjects were enrolled for control group.Double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) was employed to measure the serum levels of sCD146 and mnatrix metalloproteinase-9 (MMP-9),analyze the correlation of sCD146 with MMP-9 and high sensitivity CRP (hs-CRP),and evaluate whether sCD146 correlates with plaque vulnerability.Results Soluble CD146 level was elevated in CAS patients versus healthy donors [(212 ± 43) vs (173 ± 36) ng/ml,P ＜ 0.001].And sCD146 level significantly increased in CAS patients with unstable plaques than those with stable plaque [(218 ± 28) vs (176 ± 25) ng/ml,P ＜ 0.001].And sCD146 was correlated with high-sensitivity C-reactive protein (hsCRP,r =0.370 9,P =0.018 5),a well-known marker for CAS inflammation.Also it was an independent risk factor for plaque vulnerability (OR =1.16,95％ CI:1.020-1.310,P =0.019 2).And its level was not correlated with the risk factors of CAS,such as age,homocysteine,triglyceride,total cholesterol (TC),low density lipoprotein-cholesterol (LDL-C) or high density lipoprotein-cholesterol (HDL-C) (P ＞ 0.05).But there was a good correlation with the serum level of MMP-9 in CAS patients (r =0.677 2,P ＜ 0.001).Conclusion The concentration of soluble CD146 is positively correlated with hsCRP and MMP-9 in CAS patients.And inflammation and neovascularization may interact with each other during atherosclerotic process.The serum level of sCD146 is correlated independently with plaque vulnerability.
