摘要： 目的   探讨炎细胞因子白细胞介素-17、-10（IL-17、IL-10）和基质金属蛋白酶-12（MMP-12）与颈动脉粥样硬化斑块易损性及脑梗死的关系。方法   根据临床卒中事件将70 例患者分为无症状性颈动脉粥样硬化（ACAS）组和急性动脉粥样硬化性脑梗死（AACI）组，并根据颈部血管彩色超声结果分为易损性斑块组和非易损性斑块组，酶联免疫吸附试验测定各组受试者血清IL-17、IL-10 和MMP-12 水平。结果   各组患者血清IL-17、IL-10 及MMP-12 表达水平比较，差异均有统计学意义（P = 0.000）。其中AACI 组患者血清IL-17 及MMP-12 分别高于ACAS 组和正常对照组（均P = 0.000），而AACI 组患者血清IL-10 表达水平低于正常对照组和ACAS 组（均P = 0.000），后两组之间差异无统计学意义（P =0.275）。易损性斑块组患者血清IL-17 和MMP-12 表达水平高于非易损性斑块组（P = 0.000，P = 0.014），而血清IL-10 表达水平低于非易损性斑块组和正常对照组（P = 0.000），后两组之间差异无统计学意义（P = 0.742）。相关分析显示，血清IL-17表达水平与MMP-12呈正相关（r = 0.640，P = 0.000）、与IL-10呈负相关（r =-0.430，P = 0.000），MMP-12与IL-10之间呈负相关（r =-0.242，P = 0.013）。结论   IL-17、IL-10及MMP-12 均参与了动脉粥样硬化及其脑梗死的病理过程，IL-17、MMP-12 水平升高及IL-10 水平下降与斑块易损性密切相关，其结果有助于临床早期发现动脉粥样硬化斑块的易损性及预测急性缺血性脑卒中事件的发生。

关键词: 动脉粥样硬化, 颈动脉狭窄, 白细胞介素10, 白细胞介素17, 基质金属蛋白酶类, 脑梗死

Abstract: Objective To investigate the relationship of IL-17, IL-10 and MMP-12 with the vulnerability of carotid atherosclerotic plaque and cerebral infarction. Methods According to clinical stroke event 70 carotid atherosclersis patients were divided into asymptomatic carotid atherosclerosis (ACAS) group (n = 35) and acute atherosclerotic cerebral infarction (AACI) group (n = 35). The patients were also divided into vulnerable plague (VP) group (n = 38) and unvulnerable plague (UVP) group (n = 32) by color ultrasonic technique. Normal control group (n = 35) was established. The plasma levels of cytokines were tested by enzyme-linked immunosorbent assay (ELISA). Results Compared with the control group, the concentrations of IL-17, IL-10 and MMP-12 in ACAS group and AACI group were significantly elevated (P = 0.000; P = 0.000), moreover, the concentrations of IL-17 and MMP-12 in AACI group were higher than those in ACAS group (P = 0.000; P = 0.002, respectively). In AACI group, the level of IL-10 was lower than the ACAS group and control group (P = 0.000, for all), whereas, no significant difference of IL-10 level was seen between ACAS group and control group (P = 0.275). In VP group, the concentrations of IL-17 and MMP-12 were higher than those in UVP group (P = 0.000 and 0.014, respectively). In VP group, the level of IL-10 was lower than that in UVP group and control group (P = 0.000, for all), but no significant difference of IL-10 level was seen between UVP group and control group (P = 0.742). Correlation analysis showed, the level of IL-17 was positively correlated with the level of MMP-12 (r = 0.640, P = 0.000), and was negatively correlated with the level of IL-10 (r =-0.430, P = 0.000). The level of MMP-12 was weakly negatively correlated with the level of IL-10 (r =-0.242, P = 0.013). Conclusion IL-17, IL-10 and MMP-12 all participate the pathological process of atherosclerosis and cerebral infarction. The elevated IL-17 and MMP-12 levels and decreased IL-10 level may be closely correlated with the plague vulnerability. These results would be helpful to discover the vulnerability of plague in the early stage and to predict the incidence of acute ischemic stroke.

Key words: Atherosclerosis, Carotid stenosis, Interleukin-10, Interleukin-17, Matrix metalloproteinases, Brain infarction