脑梗死动脉粥样硬化斑块稳定性与血浆MMP-9、TGF-β1、TIMP-1表达相关性研究

发布时间：2018-05-03 19:49

本文选题：脑梗死 + 动脉粥样硬化斑块　；参考：《中南大学》2014年硕士论文

【摘要】：目的：探讨脑梗死患者血浆中基质金属蛋白酶-9(MMP-9)、转化生长因子-β1(TGF-β1)、金属蛋白酶组织抑制剂-1(TIMP-1)表达与颈动脉粥样硬化斑块稳定性的相关性。方法：筛选84例脑梗死患者为脑梗死组和21例健康人群为对照组,根据颈动脉彩超检查结果脑梗死组分为动脉硬化组、稳定斑块组、不稳定斑块组三个亚组。所有研究对象均收集一般临床资料及血糖、血脂等实验室资料。采取酶联免疫吸附试验法(ELISA)测定血浆中MMP-9、TGF-β1、TIMP-1水平。采用方差分析比较不同组间MMP-9、 TGF-β1、TIMP-1、MMP-9/TIMP-1差异；采用有序logistic回归分析了解MMP-9、TGF-β1、TIMP-1水平的变化与动脉粥样硬化斑块稳定性的关系。结果：1.一般临床资料及实验室资料比较：对照组与脑梗死组患者在性别、吸烟史、饮酒史分布及年龄、HDL、TG、CHOL水平上差异不具有统计学意义(P0.05),在糖尿病史、高血压病史分布及LDL、FBS、IMT水平上差异具有统计学意义(P0.05)；2.硬化组与对照组相比血浆MMP-9、TIMP-1含量增加,MMP-9/TIMP-1比值增大,血浆TGF-β1含量降低,除MMP-9/TIMP-1比值增大差异有统计学意义(P0.05),其余各指标血浆含量变化均无统计学差异(P0.05)；与对照组、硬化组相比,稳定斑块组、不稳定斑块组血浆MMP-9、TIMP-1含量增加,MMP-9/TIMP-1比值增大,血浆TGF-β1含量降低,差异有统计学意义(P0.05)；稳定斑块组与不稳定斑块组相比血浆MMP-9、TIMP-1含量增加,MMP9/TIMP1(?)比值增大,血浆TGF-β1含量降低,差异有统计学意义(P0.05)。3.有序变量logistic回归分析提示：MMP-9不能使颈动脉斑块易损风险增加(OR=0.965,95%CI:-2.572-3.815,P0.05);TGF-β1能使颈动脉斑块易损风险降低(OR=0.582,95%CI:0.251-0.862, P0.05); TIMP-1能使颈动脉斑块易损风险增加(OR=2.364;95%CI:1.415-2.374, P0.01)。结论：1. TGF-β1、MMP-9、TIMP-1的水平改变可能参与了颈动脉粥样硬化斑块的形成及稳定性的维持。2.TGF-β1、MMP-9/TIMP-1表达失调可能是颈动脉粥样硬化斑块发生及进展的重要机制之一。3.TGF-β1是颈动脉粥样硬化斑块稳定性的保护因素。
[Abstract]:Objective: to investigate the relationship between the expression of matrix metalloproteinase-9 (MMP-9), transforming growth factor- 尾 1 (TGF- 尾 1) and tissue inhibitor of metalloproteinase (TIMP-1) in patients with cerebral infarction and the stability of carotid atherosclerotic plaque. Methods: 84 patients with cerebral infarction were selected as cerebral infarction group and 21 healthy people as control group. According to the results of carotid ultrasound, cerebral infarction group was divided into three subgroups: arteriosclerosis group, stable plaque group and unstable plaque group. All subjects collected general clinical data, blood sugar, blood lipid and other laboratory data. The level of MMP-9 TGF- 尾 1 and TIMP-1 in plasma was determined by enzyme linked immunosorbent assay (Elisa). The differences of MMP-9, TGF- 尾 1 and TIMP-1 / TIMP-1 were compared by ANOVA, and the relationship between the changes of MMP-9, TGF- 尾 1and TIMP-1 and the stability of atherosclerotic plaques was studied by logistic regression analysis. The result is 1: 1. Comparison of general clinical data and laboratory data: there were no significant differences in sex, smoking history, distribution of drinking history and age of HDLT TGG Chol between the control group and the cerebral infarction group (P 0.05), but there was no significant difference between the two groups in the history of diabetes mellitus. There were significant differences in the distribution of hypertension history and the IMT level of LDLN FBSU (P 0.05). Compared with the control group, the plasma MMP-9 / TIMP-1 ratio increased and the plasma TGF- 尾 1 content decreased in the sclerosing group, with the exception of the increase in the MMP-9/TIMP-1 ratio, there was no significant difference in the plasma levels of the other indexes (P 0.05), and there was no significant difference between the sclerosing group and the sclerosing group. In stable plaque group, the content of MMP-9 / TIMP-1 increased and the ratio of MMP-9 / TIMP-1 increased, the content of TGF- 尾 1 decreased, the difference was statistically significant (P 0.05), and the content of MMP-9 and TIMP-1 in stable plaque group was higher than that in unstable plaque group (P < 0.05). The plasma TGF- 尾 1 content decreased with the increase of the ratio, and the difference was statistically significant. The logistic regression analysis showed that MMP-9 could not increase the risk of carotid plaque vulnerability. CI: -2.572-3.815 and TGF- 尾 1 could reduce the risk of carotid plaque vulnerability by 0.58295 CI: 0.251-0.862, P 0.055.The TIMP-1 could increase the risk of carotid plaque vulnerability by 2.36495% CI 1.415-2.374, P0.01. Conclusion 1. TGF- 尾 1, MMP-9 and TIMP-1 may be involved in the formation and stability of carotid atherosclerotic plaques. 2. TGF- 尾 1 MMP-9 / TIMP-1 expression imbalance may be one of the important mechanisms of carotid atherosclerotic plaque occurrence and progression. 3. TGF- 尾 1 is carotid atherosclerotic plaque. The protective factor of stability.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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