血清组织蛋白酶K、胱抑素C水平与缺血性脑血管病患者颈动脉粥样硬化斑块稳定性的关系

摘要

目的:探讨血清组织蛋白酶K(Cat K)和胱抑素C(Cys C)水平与超声评价的缺血性脑血管病患者颈动脉粥样硬化斑块稳定性的关系.方法:167例缺血性脑血管病患者根据颈动脉超声检查结果分为无斑块组53例、稳定斑块组53例和不稳定斑块组61例,采用ELISA法测定3组患者血清Cat K、Cys C水平.结果:3组血清Cat K和Cys C水平差异有统计学意义(F=7.539和2.733,P均＜0.05).与稳定斑块组及无斑块组比较,不稳定斑块组血清Cat K水平较高,而Cys C水平较低(P<0.05).非条件logistic回归分析结果显示,在多因素校正后,Cat K仍为颈动脉不稳定的危险因素(OR=1.229,95%CI=1.089~1.388),Cys C为保护性因素(OR=0.995,95%CI=0.991~0.999).结论:组织蛋白酶Cat K及其内源性抑制剂Cys C表达失衡可能是缺血性脑血管病患者颈动脉粥样硬化斑块不稳定的机制之一.%Aim:To explore the relationships between the serum levels of cathepsin K ( Cat K ) and cystatin C ( CysrnC ) and stability of carotid atherosclerostic plaquein in patients with ischemic cerebrovascular disease. Methods:A total ofrn167 patients with ischemic cerebrovascular disease were performed carotid ultrasonographic exam, among whom, 53 patientsrnwere without plaque, 53 were with stable plaque and 61 were with unstable plaque. The serum Cat K and Cys C levels ofrnthe patients were determined by ELISA. Result:There were significant differences in the serum levels of Cat K and Cys C amony the 3 groups( F = 7.539 ,2.733 ,P <0.05 ). The serum level of Cat K in unstable plaque group was higher, while that of Cys C was lower( P <0. 05 ). Logistic regression revealed that:Cat K was a risk factor ( OR = 1. 229 ,95% CI = 1.089 ~1. 388 ), while Cys C was a protective factor( OR =0. 995,95% CI =0. 991 ~ 0. 999 )for the carotid unstable plaque. Conclusion:In the patients with ischemic cerebrovascular disease, the imbalance between Cat K and Cys C is one of the factors leading to unstable plaque.