【作者】 王桂斌；

【导师】 刘运海；

【作者基本信息】 中南大学 ， 神经病学， 2007， 硕士

【摘要】 背景与目的：动脉粥样硬化是缺血性脑血管病的重要病因。近年研究表明，巨细胞病毒感染对动脉粥样硬化发生、发展有着重要作用，且与动脉粥样硬化相关性脑梗死关系密切，是此两者重要危险因素。研究证实脂联素可以从多方面对动脉粥样硬化、甚至脑梗死起保护作用，是动脉粥样硬化的保护因子；多数学者认为IL-6在动脉粥样硬化及脑梗死发生、发展中起促进作用。本研究的目的在于探讨巨细胞病毒感染与脑梗死患者颈动脉内膜中层厚度的关系以及对血清脂联素、IL-6水平的影响，分析巨细胞病毒感染是否与脂联素、IL-6共同参与动脉粥样硬化、脑梗死的形成，以期对巨细胞病毒感染促进动脉粥样硬化形成的病理生理机制有进一步了解。方法：选取2005年12月至2007年4月163医院收治新发脑梗死患者101例，根据检测结果分为病毒阴性组、病毒阳性组，并设同期体检健康、HCMVIgG阴性者40例为对照组。彩超检测颈动脉内膜中层厚度并用金标法、ELISA法测定患者巨细胞病毒抗体IgG、脂联素、IL-6水平，比较各组内膜中层厚度及脂联素、IL-6水平，统计结果以SPSS12.0处理。结果：1．病毒阳性组内膜中层厚度与阴性组、对照组相比有显著差异，P＜0.01：2．脂联素在阳性组较阴性组及对照组明显降低，P＜0.01；3．IL-6在阳性组较阴性组、对照组明显升高，P＜0.01；4．脂联素与IL-6相关分析提示：两者呈负相关，Kendell相关系数=-0.455，P＜0.001；5．内膜中层厚度与IL-6水平呈正相关，Kendell相关系数=0.339，P＜0.001。结论：巨细胞病毒感染可能通过升高血清IL-6水平，降低脂联素水平，从而破坏血管保护机制，促进进动脉粥样硬化的形成，可能为巨细胞病毒感染促进动脉粥样硬化形成、从而诱发脑梗死的发生机制之一。更多还原

【Abstract】 Background and Purpose:It is known that atherosclerosis(AS) is one of the most importantcauses of ischemic cerebral-vascular diseases .Research in recent yearsshown that cytomegalovirus infection takes an important effect on theetiology and progression of atherosclerotic plaques. And someresearchers believe that cytomegalovirus infection is related with bothAS and cerebral infarction(CI). There are other studies affirms thatadiponectin as a kind of protective factor takes a positive effect onprotecting artery from atherosclerosis and prevents cerebral infarctionfrom many aspects. It is known that interleukin-6 as inflammation factorstakes an impulsing effect on the development and progression of AS andCI. It’s the objective to study the relationship between thecytomegalovirus infection and the IMT of the common carotid artery andits effect on the serum level of adiponectin and interleukin-6,and todetect it whether working by the effect on the serum level ofadiponectin and interleukin-6 during the development and progression of AS and CI so that we can go deep into the researching of itsmechanism.Methods:101 patients with the first stroke attack from the year 2005 to 2007were selected and divided into two groups included patients withoutHCMV infection and patients with HCMV infection,meanwhile fortypeople examined in the hospital Who were healthy and whose HCMVIgG were negative were selected as control group.The intima-mediathickness(IMT)of the common carotid artery were measured, meanwhilethe levels of serum adiponectin and interleukin-6 were measured byELISA and dot immunogold assay were used for the detection of IgGantibodies against HCMV. The IMT of the common carotid artery and thelevels of serum adiponectin and interleukin-6 were compared .Thestatistics were dealt with SPSS 12.0.Result:1. Compared with the negative group and control groups, the IMT ofthe common carotid artery increased significantly in the positivegroup, p＜0.01;2. Compared with negative and control groups, the levels of serumadiponectin decreased significantly in the positive group,p＜0.01;3. The levels of serum interleukin-6 in the positive group is higherthan that in the negative group and control groups, p＜0.01; 4. Correlation analysis on adiponectin and intedeukin-6 shown thatthe levels of serum adiponectin was negative correlated with the levels ofserum intedeukin-6(r=-0.455,P＜0.001);5. IMT was positive correlated with the levels of serumintedeukin-6(r=0.339,P＜0.001).Conclusion:The HCMV infection can increase the level of serum interleukin-6which decreases the level of serum adiponectin, and the protectivemechanism are destroyed, then atherosclerosis occurred at last, whichmay be one way of the development of atherosclerosis and cerebralinfarction due to HCMV infection.更多还原