转化生长因子β1对动脉粥样硬化性脑梗死患者斑块稳定性的影响研究

摘要

Objective To investigate the impact of TGF - β1 on plaque stability of patients with atherosclerotic cerebral infarction. Methods From January 2013 to January 2015,a total of 160 outpatients admitted to Outpatient Clinic of Encephalopathy Division,Traditional Chinese Medicine Hospital of Liuzhou were selected,all of them accompanied with symptoms of cerebral ischemia(like dizziness) and received brain CT or MRI examination,and they were divided into three groups:A group(with atherosclerotic cerebral infarction,n = 80),B(with carotid artery atherosclerotic plaque,n = 50),C (without intracranial lesions or carotid artery atherosclerotic plaque,n = 30). ELISA was used to detect the serum TGF - β1 level,serum TGF - β1 level and carotid intima media thickness(CIMT)were compared among the three groups,and plaque morphology,plaque types,artery stenosis degree and artery stenosis rate were compared between A group and B group. Results Serum TGF - β1 level of A group was statistically significantly lower than that of B group,C group,respectively,and serum TGF - β1 level of B group was statistically significantly lower than that of C group ( P < 0. 05 ) . By color Doppler ultrasonography,a total of 105 plaques of A group were found,a total of 84 plaques of B group were found,no one of C group found any plaques. Of A group,plaques were mainly with severe irregular surface and lipid type;of B group,plaques were mainly with regular surface and fiber calcification type,there was statistically significant differences of plaque morphology and plaque types between A group and B group(P < 0. 05). No statistically significant differences of artery stenosis degree or artery stenosis rate was found between A group and B group ( P > 0. 05 ). Conclusion Patients with unstable carotid artery atherosclerotic plaque have high risk of atherosclerotic cerebral infarction,and TGF - β1 play an important role in the maintaining of plaque stability.%目的：探讨转化生长因子β1（TGF -β1）对动脉粥样硬化性脑梗死患者斑块稳定性的影响。方法选取2013年1月—2015年1月在柳州市中医院脑病科门诊就诊者160例，均伴有头昏等脑缺血症状，常规行颅脑 CT 或MRI 检查。根据检查结果分为 A 组（n =80）、B 组（n =50）、C 组（n =30）。A 组为经颅脑 CT 或 MRI 检查确诊为动脉粥样硬化性脑梗死患者；B 组为经颅脑 CT 或 MRI 检查无脑梗死，经彩色多普勒超声检查确诊存在颈动脉粥样硬化斑块者；C 组为经颅脑 CT 或 MRI 检查无颅内病变，经彩色多普勒超声检查无颈动脉粥样硬化斑块者。采用酶联免疫吸附试验检测血清 TGF -β1水平，比较3组患者血清 TGF -β1及颈动脉内膜中膜厚度（IMT），比较 A 组和 B 组患者斑块形态、斑块类型及动脉狭窄程度、动脉狭窄率。结果 A 组患者血清 TGF -β1水平低于 B 组和 C 组，B 组患者血清 TGF -β1水平低于 C 组（P <0.05）。A 组和 B 组颈动脉 IMT 大于 C 组（P <0.05）。经彩色多普勒超声检查 A 组患者发现105个斑块，B 组患者发现84个斑块，C 组受试者无斑块。A 组患者以表面重度不规则型、脂质型斑块为主；B组患者以表面规则型、纤维钙化型斑块为主。两组患者斑块形态及斑块类型比较，差异有统计学意义（P <0.05）。A组和 B 组患者颈动脉狭窄程度及狭窄率比较，差异无统计学意义（P >0.05）。结论颈动脉粥样硬化斑块不稳定患者易发生动脉粥样硬化性脑梗死，而 TGF -β1对颈动脉粥样硬化斑块的稳定性有一定影响。