钙化与颈动脉粥样硬化斑块脆性：钙化程度与纤维帽炎症因子基因表达之间的反转关系  

Calcification and carotid plaque vulnerability：inverse relationship between the degree of calcification and fibrous cap pro-inflammatory gene expression

作　　者：郑维[1] 康红[2] 舒畅[3] 唐梅徕[1] 范培芝[1] 王盟[1] 

机构地区：[1]湖南省人民医院普外二科,湖南长沙410005 [2]湖南省人民医院急诊科 [3]中南大学湘雅二医院血管外科

出　　处：《中国医师杂志》2008年第6期758-761,共4页Journal of Chinese Physician

摘　　要：目的动脉粥样硬化患者病变斑块的炎症反应和钙化是很常见的。本研究的目的是利用颈动脉内膜切除术（CEA）切除的斑块标本比较未钙化与钙化斑块上纤维帽及周边区域上一些炎性因子、抗炎因子及成骨介质的基因表达情况。方法依据1995年美国心脏协会的协议将22个CEA斑块分为Va（非钙化，n=11）和Vb（钙化，n=11）。制作冰冻组织切片通过染色定量测量的方法测得Va中颈动脉狭窄和钙化面积的平均百分比分别为76．4％和0％，Vb为74．2％和33．6％。用显微镜激光切割机切取22个斑块的冰冻切片上的纤维帽和周边区域组织，提取总RNA后反转录成cDNA，用定量PCR的方法检测炎性因子（IL-1，IL-8和MCP—1）、抗炎因子（IL—10）及成骨介质（BMP-6和Osteocalcin）的基因表达。结果Va斑块中MCP-1，IL-8和IL-1炎性因子的mRNA的表达分别为Vb斑块的6．7（P〈0．05），3．6（P〈0．05）和1．8倍。Vb斑块中抗炎因子（IL-10）及成骨介质（BMP-6和Osteocalcin）的mRNA表达分别为Va斑块的3．8，4．2和6．9倍（P〈0．05）。结论纤维帽上的炎症和断裂的机会可能更易发生在未钙化的动脉粥样硬化斑块上。Objective Inflammation and calcification are common phenomenons in human atherosclemtic plaque. The objective of this study was to determine the gene expression of some proteins and anti-inflammatory factors as well as bone formation mediators in the fibrous cap and shoulder region of non-calcified and calcified carotid endarterectomy （ CEA ） plaques. Methods Twenty-two CEA plaques were classified as Va （ non-calcified, n = 11 ） and Vb （ calcified, n = 11 ） in accordance with the AHA consensus in 1995. Mean percent in carotid stenosis and calcification area was 76. 4% and 0% in Va and 74. 2% and 33.6% in Vb respectively as determined by quantitative histomorphometry. Using laser capture mierodissection, the fibrous cap and shoulder regions were excised from 22 frozen sections/plaques. After total RNA extraction and reverse transcription, gene expression of proteins （ IL-1, IL-8, and MCP-1 ）, anti-inflammatory factor （ IL- 10） and bone formation protein （BMP-6 and Osteocalcin） were detected by Real-time PCR. Results mRNA expression of MCP-1, IL-8 and IL-1 in Va plaques were 1.8 fold higher than that in Vb plaques, mRNA expression of anti-inflammatory factor IL-10 and osteogenic related genes BMP-6 and Osteocalcin were 3.8, 4. 2, and 6.9 fold higher in Vb plaques compared to Va plaques. Conclusions Our findings indicate that fibrous cap inflammation and susceptibility to disruption is more likely to occur in non-calclfied plaques.

关 键 词：动脉硬化/病理生理学 钙质沉着症 炎症趋化因子类 基因表达 

分 类 号：R543.4[医药卫生—心血管疾病] R541.404[医药卫生—内科学]