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目的:探讨不同类型脑白质疏松(LA)患者颈动脉斑块稳定性及其与基质金属蛋白酶2(MMP-2)和基质金属蛋白酶9(MMP-9)水平的关系。方法:将入组的LA患者根据头颅MRI表现分为脑室周围型组,皮质下型组和混合型组。应用颈动脉彩超检测其颈动脉斑块并分为稳定性和不稳定性斑块,计算斑块积分。ELISA法检测MMP-2及MMP-9水平。结果:①皮质下型组和混合型组斑块阳性率及不稳定颈动脉斑块积分均较脑室周围型组显著增高(P<0.05);②皮质下型组和混合型组的MMP-2、MMP-9水平与脑室周围型组相比差异均有显著统计学意义(P<0.01);③3组LA患者的MMP-9水平与不稳定斑块积分均呈正相关。结论:皮质下型和混合型组LA患者的颈动脉斑块阳性率及斑块不稳定性均较脑室周围型高;皮质下型组的MMP-2和MMP-9水平与脑室周围型组比存在差异;MMP-9水平与不稳定斑块积分呈正相关,提示皮质下型LA与颈动脉斑块存在一定相关性。
Objective: To investigate the stability of carotid plaques and its relationship with the expression of matrix metalloproteinase 2 (MMP-2) and matrix metalloproteinase 9 (MMP-9) in different types of patients with leukoaraiosis (LA). Methods: The patients with LA were divided into periventricular type, subcortical type and mixed type according to the manifestations of head MRI. The carotid plaques were detected by carotid ultrasonography and divided into stable and unstable plaques. The plaque score was calculated. ELISA assay MMP-2 and MMP-9 levels. Results: ①The positive rate of plaque and the score of unstable carotid artery plaque were significantly higher in patients with subcortical and mixed type than those in peripheral type (P <0.05); ② The expressions of MMP-2 (P <0.01). The level of MMP-9 in LA patients was positively correlated with unstable plaque score in the three groups. Conclusion: The positive rate of carotid artery plaque and plaque instability in patients with subcortical and mixed LA were higher than those in periventricular. The levels of MMP-2 and MMP-9 in subcortical as compared with those in peripheral ventricles There was a positive correlation between MMP-9 level and unstable plaque score, suggesting that there is a certain correlation between subcortical LA and carotid artery plaque.