Department of Neurology, Kyoto Prefectural University of Medicine, 465 Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, Japan.
J Interferon Cytokine Res. 2009 Nov;29(11):729-34. doi: 10.1089/jir.2009.0012.
The mechanism of the inflammatory response in the vascular wall in atherothrombosis and during the progression of atherosclerosis has attracted attention. We focused on the potential usefulness of inflammatory markers in chronic recurrent brain infarction, and analyzed the role of inflammatory markers in atherosclerosis of the intracranial artery. The subjects were 2 groups of patients treated between 2004 and 2006: a group of outpatients with recurrent infarction (group RI), who developed atherothrombotic brain infarction twice; another group of outpatients with brain infarction without recurrence (group BI), who developed brain infarction once and remained free of recurrence for >1 year; and a group of control subjects with normal brain magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) (group C). Plasma samples were collected from each group of patients for the simultaneous measurement of 17 kinds of candidate inflammatory markers, using a fluorescent microbead array system, and the results were compared with head MRA findings. The levels of high-sensitivity C-reactive protein (hsCRP) and monocyte chemoattractant protein-1 (MCP-1) were significantly higher in group RI patients than in groups C and BI. Subjects with a hsCRP level > or =0.3 and a MCP-1 level > or =200 in the serum have, respectively, a 1.92 and 2.98 relative risk to have a potential recurrent infarction. Regarding the relation of inflammatory marker levels with MRA findings, group RI showed significantly higher levels of hsCRP at M1 lesions and MCP-1 at A1 and M1 lesions than group BI (P < 0.05). In conclusion, the MCP-1 level as well as hsCRP in the blood can be a potential predictive marker of recurrent thrombotic brain infarction, and may reflect inflammation that promotes intracranial large-artery atherosclerosis.
动脉血栓形成和动脉粥样硬化进展过程中血管壁炎症反应的机制引起了人们的关注。我们关注了炎症标志物在慢性复发性脑梗死中的潜在作用，并分析了炎症标志物在颅内动脉粥样硬化中的作用。研究对象为 2004 年至 2006 年期间治疗的 2 组患者：一组为复发性脑梗死门诊患者（RI 组），发生了 2 次动脉血栓性脑梗死；另一组为无复发脑梗死门诊患者（BI 组），发生了 1 次脑梗死，且 1 年以上无复发；还有一组为磁共振血管造影（MRA）正常的对照组（C 组）。从每组患者中采集血浆样本，使用荧光微球阵列系统同时测量 17 种候选炎症标志物，并将结果与头部 MRA 结果进行比较。RI 组患者的高敏 C 反应蛋白（hsCRP）和单核细胞趋化蛋白-1（MCP-1）水平明显高于 C 组和 BI 组。血清 hsCRP 水平≥0.3 和 MCP-1 水平≥200 的患者发生潜在复发性梗死的相对危险度分别为 1.92 和 2.98。关于炎症标志物水平与 MRA 结果的关系，RI 组 M1 病变的 hsCRP 和 A1 和 M1 病变的 MCP-1 水平明显高于 BI 组（P＜0.05）。总之，血液中的 MCP-1 水平以及 hsCRP 可能是复发性血栓性脑梗死的潜在预测标志物，并可能反映促进颅内大动脉粥样硬化的炎症。
