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缺血性脑血管病患者颈动脉粥样硬化斑块不稳定性与血脂及外周血相关因子的关系 被引量:1

Relationship of instability of carotid atherosclerotic plaque with related factors of blood lipid and peripheral blood in patients with ischemic cerebrovascular disease
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摘要 目的:对缺血性脑血管病患者的颈动脉粥样硬化损害进行了彩色超声检查分型、脑部病灶的计数、以及部分外周血循环中因子的相关性分析,探讨炎症在缺血性脑血管病患者颈动脉粥样硬化斑块不稳定性中的作用。方法:选择2002-12/2003-12在郑州大学第一附属医院神经内科住院的112例缺血性脑血管患者,按颈动脉超声表现分为3组:颈动脉正常组33例、稳定型斑块组38例、不稳定斑块组41例;比较3组患者颅脑CT平片颈内动脉分区梗死灶计数;外周血白细胞计数、单核细胞计数、淋巴细胞计数、血浆纤维蛋白原及血脂各项指标检查。结果:112例患者全部进入结果分析。①颈内动脉分布区病灶计数:CT平片显示不稳定斑块组明显高于正常组和稳定型斑块组犤(3.95±1.91)个,(2.12±1.26)个,(2.32±1.62)个,P=0.001,0.031犦。②血脂各项指标检查结果:不稳定斑块组血浆总胆固醇、三酰甘油、低密度脂蛋白浓度明显高于正常组和稳定型斑块组犤(6.89±1.47),(5.26±1.63),(4.52±1.04)mmol/L;(2.65±1.72),(1.83±1.21),(1.34±0.96)mmol/L;(4.98±2.36),(3.37±1.16),(2.16±0.96)mmol/L;P<0.05犦。3组患者载脂蛋白A1,载脂蛋白B,高密度脂蛋白,脂蛋白α含量无明显变化(P>0.05)。③外周血中白细胞计数及血浆纤维蛋白原含量:不稳定斑块组白细胞计数、单核细胞计数、淋巴细胞计数、血浆纤维蛋白原含量明显高于正常组和稳定型斑块组犤(8.99±1.87),(7.50±2.38),(6.71±1.41)×109L-1;(1.09±0.54),(0.68±0.48),(0.36±0.23);(3.99±2.31),(2.85±1.84),(2.11±0.97);(4.19±1.24),(3.45±0.82),(2.23±0.62)g/L;P<0.05犦。结论:①颈动脉粥样硬化的发生和斑块不稳定性与血脂中总胆固醇、三酰甘油、低密度脂蛋白以及炎症因子中白细胞计数、单核细胞计数、淋巴细胞计数和血浆纤维蛋白原有关。②基于颅脑CT平片的颈内动脉分布区梗死病灶计数可以反映颈动脉粥样硬化斑块的稳定性。 AIM: To conduct a correlative analysis of the damage of carotid atherosclerosis in patients with ischemic cerebral vessels disease is done on color ultrasonic examination typing, the number of focus on brain and part of factors of peripheral blood circulation so as to explore the effects of inflammation on the instability of carotid atherosclerostic plaques in patients with ischemic cerebrovascwlar disease. METHODS: 112 patients with cerebral vessels ischemia were selected from the Department of Neurology of First Affiliated Hospital of Zhengzhou University between December 2002 and December 2003 and divided into 3 groups according to their carotid ultrasonic examination: carotid normal group with 33 patients, stable plaque group with 38 patients, unstable plaque group with 41 patients; Patients in the three groups were compared on number of infarct focus in internal carotid artery of craniocerebral CT plain film; peripheral numeration of leukocyte count, monocyte count, lymphocyte count, plasm fibrinogen and each index check of blood lipid. RESULTS: Totally 112 patients were involved in the analysis of results. ① Number of focus in internal carotid artery area: The CT plain fil display in unstable plaque group was significantly higher than that in carotid normal group and stable plaque group [(3.95±1.91, 2.12±1.26, 2.32±1.62)pieces,(P=0.001, 0.031)]. ② The check result of each index of blood-fat: The content of plasm total cholesterol, triglyceride and low density lipoprotein in unstable plaque group was significantly higher than that in carotid normal group and stable plaque group [(6.89±1.47), (5.26±1.63), (4.52±1.04) mmol/L ; (2.65±1.72), (1.83±1.21), (1.34±0.96) mmol/L; (4.98±2.36), (3.37±1.16), (2.16±0.96) mmol/L; P 〈 0.05]. There were insignificant differences in apolipoprotein A1, apolipoprotein B, high density lipoprotein and lipoprotein a in patients of the three groups (P〉 0.05). ③ The content of numeration of leukocyte and plasm fibrinogen: The content of numeration of leukocyte, monocyte count, lymphocyte count, plasm fibrinogen in unstable plaque group was significantly higher than that in carotid normal group and stable plaque group [(8.99±1.87), (7.50±2.38), (6.71±1.41)×10^9 L^-1; (1.09±0.54), (0.68±0.48), (0.36±0.23) ; (3.99±2.31), (2.85±1.84), (2.11±0.97); (4.19±1.24), (3.45±0.82), (2.23±0.62) g/L; (P〈 0.05)]. CONCLUSION: ① The occurrence of carotid atherosclerosis and the instability of plaques have a relation with total cholesterol, triglyceride and low density lipoprotein in blood-fat and numeration of leukocyte, monocyte count, lymphocyte count, plasm fibrinogen in inflammation factors. ② Number of infarct foci in internal carotid artery area based on craniocerebral CT plain film can reflect the stability of carotid atherosclerotic plaque.
出处 《中国临床康复》 CAS CSCD 北大核心 2005年第25期70-72,共3页 Chinese Journal of Clinical Rehabilitation
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参考文献7

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