C-reactive Protein And Placental Growth Factor Expression In Human Carotid Atherosclerotic Plaques

Objective:Cerebrovascular diseases which caused by arotid atherosclerosis have become a serious threat to people's health and quality of life, with improved living standards. To study the etiology of atherosclerosis and the pathogenesis of cerebrovascular disease for pre-treatment measures become urgent needs. Through clinical observation of the plaques in patients undergoing certain factors in the expression of a variety of plaques, to explore the stability of atherosclerotic plaque in the role of clinical patients to reduce disability, the risk of death for interventions.Methods:Plaques were collected from carotid endarterectomy patients that surgered in Zheng Zhou university the fifth Affiliated vascular surgery in January 2008 to June 2009. Subjects with each patient signed a carotid artery atherosclerosis research informed consent form.Inclusion criteria:①With cerebral infarction, hypertension, diabetes, hyper-lipidemia, coronary heart disease among at least one or more of the history;②The CEA surgical indication exists.Exclusion criteria:①There are new cerebral infarction evidences with CT;②With a clear liver, kidney or heart failure, tumor, systemic infections, autoimmune diseases;③Onset within 1 month before surgery and 6 months with a history of myocardial infarction;④With vascular inflammatory disease, and Lesions in the active stage, ESR>30mm/h;⑤Taking drugs inhibit inflammation, immune inhibitors or hormone drugs;⑥The abnormal white blood cell count of routine blood tests;⑦A bleeding or a coagulating disorder for any reason;⑧Having taboo that can not be tolerated general anesthesia;⑨Can not obtain informed consent. With the above standard, extracting 55 patients experimented. Patients were divided into symptomatic group and asymptomatic group. Symptomatic group inclusion criteria:Preoperative 6 months or more times within a transient ischemic (TIA, if a short of dizziness, limb weakness or numbness, salivation and other pathological neurological syndromes), showed within 24h obvious limitations of neurological dysfunction, or single-blind and whether caused by mild or disabling stroke signs, regardless of whether the more than 70% stenosis. Symptomatic group of 25 cases selected. Asymptomatic group of selection criteria:There are not any neurological symptoms and signs and preoperative TIA attacking in six months, but after CTA confirmed the internal carotid artery stenosis greater than 70%. Asymptomatic group of 25 cases selected. In addition, for the symptomatic patient group within the TIA attacking frequency within six months as a standard, divising 3 levels:Ⅰgrade:1～2 times;Ⅱgrade:3～5 times;Ⅲgrade:6 or more times.The protein extracted liquid from atheromatous plaques were measured by ELISA and Western-Blotting to detect the protein expression of C-reactive protein and placental growth factors. Thorugh comparise the difference between the two groups with placental growth factors and C-reactive protein, and comparing the difference of placental growth factors expression in symptomatic patients'hierar-chical data, to judgment the corelation with placental growth factors expression and the frequency of TIA, and analysis whether it has correlation with the stability of the anteromatous plaques.Results:1. In patients with symptomatic group and asymptomatic group, age and sex showed no significant difference.2. The expression of C-reactive protein was detected in both groups with ELISA, and the average concentration of expression was (g/ml):21.44±9.43; 25.27±4.20, P=0.052,accordancing to the inspection standardsα=0.05, the concentration of CRP in two groups had no significant difference.3. The expression of placental growth factors was detected in both groups with western-blotting, and the average relative grayscale value was:21.44±9.43; 25.27±4.20, P=0.052, accordancing to the inspection standardsα=0.05, the expression level of placental growth factors in asymptomatic patients was lower than sympto-matic patients.4. As theα=0.01, R2=0.916, the correlation that compared in symptomatic patients'of gray value and the frequency of TIA attacking was significantly. During the expression of placental growth factors in symptomatic patients'plaques and the frequency of TIA attacking were positively correlated.Conclusion:1. The expression in serum has a difference that patients with carotid atherosc-lerotic plaques in the expression of CRP symptomatic patients and asymptomatic patients with no obvious difference. It shows the CRP reflects systemic inflammation in the state, but may not specificitily with local inflammation.2. Symptomatic patients carotid atherosclerotic plaques P1GF expression is obvi-ously higher than that of asymptomatic group, P1GF local high expression might through promoting local angiogenesis, causing plaque instability.3. P1GF expressing reflects the plaques' instability, which has highly correlation with TIA. Explain to make P1GF expression are likely to reduce local stability of intervention has guiding role.4. Carotid artery plaque in the local, P1GF compared with the high expression of CRP may be a better indicator of plaque instability.