| Objective To investigate the role of serum MMP-2 level,gene single nucleotide polymorphism and gene-gene interaction in the formation of carotid plaque,plaque vulnerability and cerebral infarction,and to analyze the related factors leading to cerebral infarction.To explore the combined serum MMP-2 level,gene single nucleotide polymorphism and gene-gene interaction,and to analyze the clinical significance of ultrasound diagnosis and evaluation of carotid artery plaque vulnerability.Methods Continuous collected the atherosclerotic process in the department of neurology,221 cases of cerebral infarction patients,according to the neck artery colour to exceed,and ultrasonic imaging findings,divided into vulnerable plaques group(145 cases)and non vulnerable plaque group(76 cases),which contains a set of vulnerable plaques of 55 patients with stable plaques and 21 patients with no plaque,and continuous to collect 263 cases without carotid atherosclerosis in the physical examination center of our hospital were successively collected as the control group.Serum MMP-2 levels were detected by enzyme-linked immunosorbent assay(ELISA),and the MMP-2 rs243865(-1306C/T)and rs2285053(-735C>T),rs2241145(G/C),and 23.0 SPSS statistical software and generalized multi-factor dimensionality reduction(GMDR)Beta V0.7 software were used for analysis.result 1.The proportions of male,hypertension and diabetes in cerebral infarction group were higher than those in control group.Age,homocysteine and serum MMP-2levels were higher in the cerebral infarction group than in the control group,while cholesterol,high-density lipoprotein and low-density lipoprotein levels were lower in the cerebral infarction group than in the control group(P<0.05).There were no statistically significant differences in smoking,alcohol consumption,triglycerides and uric acid between the two groups(P>0.05).2.The levels of cholesterol,low density lipoprotein,uric acid,homocysteine and serum MMP-2 in cerebral infarct vulnerable plaque group were higher than those in cerebral infarct vulnerable plaque group(P<0.05).There were no statistically significant differences in gender,age,diabetes,triglycerides,and HDL between the two groups(P>0.05).3.There were statistical differences in MMP-2 rs243865(-1306C/T)gene polymorphism between the cerebral infarction group and the control group,and between the cerebral infarction vulnerable plaque group and the cerebral infarction non-vulnerable plaque group(χ2=10.512,P=0.005;χ2=8.478,P=0.014),whereas MMP-2 rs2285053(-735C>T)and rs2241145(G/C),there was no statistically significant difference in the genotype distribution of the two polymorphisms(all P>0.05).4.Logistic regression analysis showed that gender,age,hypertension,serum MMP-2 level were independent risk factors for cerebral infarction,while smoking,hypertension,cholesterol and homocysteine were independent risk factors for the formation of cerebral infarction vulnerable plaques.MMP-2 rs243865(-1306C/T)T-site mutation was positively correlated with plaque vulnerability,and the incidence of plaque vulnerability in CC type was lower than that in mutated CT and TT type.5.GMDR analysis showed that there were significant gene-gene interactions between rs243865(-1306C/T)and rs2241145(G/C)between cerebral infarction group and control group,between cerebral infarction vulnerable plaque group and cerebral infarction non-vulnerable plaque group(sample test accuracy was 55.96%,The consistency of cross test was 10/10,and the test value was P=0.0107.The accuracy of sample test was 65.16%,the consistency of cross-test was 10/10,consistent with the test value P=0.0124),and both increased the incidence(OR: 1.517,95%CI: 1.280-1.955;OR: 1.385,95%CI: 1.187-1.795)Conclusion 1.Serum MMP-2 expression was increased in the cerebral infarction group;MMP-2 RS2285053(-735C>T)and rs2241145(G/C)played little role in cerebral infarction,while the mutation of rs243865(-1306C/T)C→T may be positively correlated with cerebral infarction.Based on the level of MMP-2,the combination of rs243865(-1306C/T)and rs2241145(G/C)gene interaction model is the best combination to promote the occurrence of cerebral infarction,which can obviously promote the occurrence of cerebral infarction.2.The expression of serum MMP-2 was increased in the vulnerable plaque group,but it was not an independent risk factor for the formation of cerebral infarction vulnerable plaque.The mutation of rs243865(-1306C/T)C→T is positively correlated with plaque vulnerability and is an independent risk factor for vulnerable plaques.The gene interaction showed that the combination of rs243865(-1306C/T)and rs2241145(G/C)of MMP-2 was the best combination for the occurrence of vulnerable plaques,which could promote the occurrence of vulnerable plaques obviously.3.Patients with carotid artery ultrasound and contrast-enhanced ultrasound evaluation as vulnerable carotid plaques,high expression of serum MMP-2,mutation of MMP-2 rs243865(-1306C/T)T site,and combination gene interaction model of rs243865(-1306C/T)and rs2241145(G/C),The incidence of atherosclerotic cerebral infarction is very high. |
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