可溶型內皮細胞selectin與早期頸動脈硬化

Soluble Endothelial-selectin and Early Carotid Atherosclerosis

羅敏智(Man-Chi Lo) ； 陳逸芸(Yi-Yun Chen) ； 郭珍菱(Chen-Ling Kuo) ； 蔡青峰(Ching-Feng Tsai) ； 劉青山(Chin-San Liu)

《The Changhua Journal of Medicine》 8卷1期 (2003/01) Pp. 28-34

摘要

背景及目的：在早期動脈硬化過程中沾黏分子(Adhesion Molecule, AM)扮演關鍵性角色。其中E-selectin (Endothelial-selectin)是AM家族中最早參與血管發炎反應分子。動脈內膜中層厚度(Intima-Media Thickness, IMT)增厚是早期動脈硬化之病理特徵，而本研究探討血漿中的sE-seleetin (soluble-selectin)與早期頸動脈硬化指標-IMT之關係。
方法：受試者共68人均無腦／心血管疾病及無服用藥物。其中健康族群佔26人、具動脈硬化危險因子（高血壓、高血糖、高血脂或吸煙）的危險群佔42人。檢查包括理學檢查、常規生化檢查、ELISA技術測量血漿sE-selectin濃度，利用頸動脈超音波檢查測量動脈硬化指標，包括代表早期變化之兩側平均頸總動脈內膜中層厚度(Common Carotid Artery-Intima-Media Thickness, CCA-IMT)及較後期變化之總硬化斑指數(Total Plaque Index, TPI)。統計分析採四分位法(quartile method)，將sE-selectin的濃度分組後，應用共變數分析(Multi-Covariant of ANOVA)，分析sE-selectin的濃度與CCA-IMT、TPI之相關性。
結果：在健康族群中CCA-IMT、TPI與sE-selectin變化並無統計之差異，而在危險族群中sE-selectin之濃度與CCA-IMT有顯著正相關(P=0.008)，但與TPI程度無關(P=0.756)，其中sE-selectin濃度增高，主要發現於吸煙族群(P=0.053)。
結論：在危險族群中血漿sE-selectin增高，可應用為偵測早期CCA-IMT增厚，或許可作為偵測早期動脈硬化之生物指標。

關鍵字

沾黏分子 ； sE-selectin ； 早期動脈硬化 ； 頸動脈超音波

並列摘要

Background: Among adhesion molecules, which play a crucial role in early atherosclerosis, endothelial-selectin (E-selectin) participates earliest the vascular inflammatory process. Increased intima-media thickness (IMT) is a pathological finding of early atherosclerosis. We investigated the relationship between plasma levels of soluble E-selectin (sE-selectin) and carotid IMT.
Materials and methods: Sixty-eight adults were enrolled: 26 healthy subjects and 42 who were at risk for atherosclerosis, including those with hypertension, hyperglycemia, hyperlipidemia, or a history of cigarette smoking. Adults with cerebrovascular or cardiovascular events or with medication exposure were excluded. All subjects underwent physical examination, routine biochemical studies, quantitation of plasma sE-selectin with sandwich-type enzyme- linked immunosorbent assay, and carotid duplex studies. We used duplex studies to measure atherosclerotic parameters, including the mean IMT of the bilateral common carotid arteries (CCA-IMT), an indicator of early atherosclerosis, and the total plaque index (TPI), an indicator of late atherosclerosis. A quartile method and a multicovariant analysis of variance were used to evaluate the effect of sE-selectin on CCA-IMT and the TPI.
Results: In the healthy group, changes in sE-selectin were not correlated with CCA-IMT or the TPI. In the at-risk group, plasma sE-selectin levels were well correlated with CCA-IMT (P=0.008) but not TPI (P=0.756). At-risk smokers had a borderline increase in sE-selectin levels (P=0.053).
Conclusion: Increased plasma levels of sE-selectin in those at risk for atherosclerosis may be used to detect early increased CCA-IMT. They may serve as a biological marker for early atherosclerosis.

並列關鍵字

adhesion molecules ； sE-selectin ； early atherosclerosis ； carotid duplex study