中文摘要：

目的 探讨血清可溶性CD146（sCD146）水平与颈动脉粥样硬化（CAS）斑块易损性的关系.方法 2011年3月至2012年9月从北京安贞医院血管外科入选40例症状性颈动脉狭窄（≥70％）患者,根据超声影像结果分为稳定斑块组（16例）和不稳定斑块组（24例）.在体检中心入选40名健康者为对照组.测定所有研究对象的sCD146水平及CAS患者的超敏C反应蛋白（hs-CRP）、金属基质蛋白酶-9（MMP-9）水平,分析sCD146与炎症反应因子的相关性,探讨sCD146与CAS斑块易损性的关系.结果 CAS患者血清sCD146水平明显高于健康对照者[（212 ±43） ng/ml比（173±36） ng/ml,P＜0.001],斑块不稳定组sCD146水平明显高于斑块稳定组[（218±28）ng/ml比（176±25） ng/ml,P＜0.0001],斑块稳定组与正常对照组sCD146水平无统计学差异[（176±25） ng/ml比（173±36） ng/ml,P=0.6395].CAS患者的sCD146水平与hs-CRP水平显著正相关（r=0.354 7,P =0.033 8）,校正hs-CRP水平,sCD146水平与CAS斑块易损性独立正相关（OR=1.16,95％ CI：1.020～ 1.310,P=0.019 2）.CAS患者sCD146水平与动脉粥样硬化危险因素：年龄、同型半胱氨酸水平以及血脂水平无关（P＞0.05）.不稳定斑块组sCD146升高明显（P＜0.001）,血清MMP-9水平也明显升高[（1027±293） ng/ml比（649±258） ng/ml,P=0.002 5],二者显著正相关（r=0.677 2,P＜0.001）.结论 CAS患者血清sCD146与hs-CRP、MMP-9水平正相关,与斑块的易损性独立正相关,提示炎症反应与斑块内血管新生在CAS的发展过程中可能有相互促进作用.

英文摘要：

Objective To explore the relationship between circulating level of soluble CD146 （sCD146） and plaque vulnerability or inflammatory factors in patients with carotid atherosclerosis （CAS）.Methods Forty CAS patients with carotid stenosis （≥ 70％） were enrolled and divided into 2 groups of stable and unstable plaque by ultrasonic imaging.And another 40 healthy subjects were enrolled for control group.Double-antibody sandwich enzyme-linked immunosorbent assay （ELISA） was employed to measure the serum levels of sCD146 and mnatrix metalloproteinase-9 （MMP-9）,analyze the correlation of sCD146 with MMP-9 and high sensitivity CRP （hs-CRP）,and evaluate whether sCD146 correlates with plaque vulnerability.Results Soluble CD146 level was elevated in CAS patients versus healthy donors [（212 ± 43） vs （173 ± 36） ng/ml,P ＜ 0.001].And sCD146 level significantly increased in CAS patients with unstable plaques than those with stable plaque [（218 ± 28） vs （176 ± 25） ng/ml,P ＜ 0.001].And sCD146 was correlated with high-sensitivity C-reactive protein （hsCRP,r =0.370 9,P =0.018 5）,a well-known marker for CAS inflammation.Also it was an independent risk factor for plaque vulnerability （OR =1.16,95％ CI：1.020-1.310,P =0.019 2）.And its level was not correlated with the risk factors of CAS,such as age,homocysteine,triglyceride,total cholesterol （TC）,low density lipoprotein-cholesterol （LDL-C） or high density lipoprotein-cholesterol （HDL-C） （P ＞ 0.05）.But there was a good correlation with the serum level of MMP-9 in CAS patients （r =0.677 2,P ＜ 0.001）.Conclusion The concentration of soluble CD146 is positively correlated with hsCRP and MMP-9 in CAS patients.And inflammation and neovascularization may interact with each other during atherosclerotic process.The serum level of sCD146 is correlated independently with plaque vulnerability.