不稳定颈动脉斑块脑梗死患者的血hs-CRP水平研究

Study of Serum hs-CRP Level in Cerebral Infarction Patients with Unstable Carotid Atherosclerotic Plaques

目的探讨颈动脉粥样硬化病变特性与脑梗死的关系，寻找不稳定性颈动脉粥样斑块可能的血清学标志。方法对88例颈内动脉系统的急性脑梗死患者进行颈动脉彩超检查，根据结果分成不稳定斑块组、稳定斑块组、无斑块组。同时行血高敏C-反应蛋白（hs—CRP）水平检测。结果①检出颈动脉粥样硬化斑块70例（79．55％），其中36例（40．91％）伴不稳定斑块且多位于梗死侧，梗死侧不稳斑块构成比显著高于非梗死侧（P〈0．001）。②不稳定斑块组hs-CRP水平高于稳定斑块组、无斑块组及对照组；危险度分析显示血hs—CRP水平升高易发生不稳定斑块（OR=2．05，95％CI1．419～7．302）；Logistic回归分析显示hs-CRP与不稳斑定块有关（P〈0．05）。结论①不稳定颈动脉粥样硬化斑块与脑梗死之间关系密切。②hs—CRP可能是一项独立的反映颈动脉硬化斑块稳定性的血清标志物。

Objective To assess the character of carotid atherosclerosis in patients with cerebral infarction and explore the possible serum markers of unstable carotid atherosclerotic plaques. Methods The ultrasonography was performed in the carotid arteries in all the 88 patients with cerebral infarction located in arteriae carotis interna system. According to the result, patients were divided into unstable plaque group,stable plaque group and nonplaque group. Serum high-sensitive C-reactive protein（hs- CRP） level was detected. Results ① Carotid atherosclerotic plaques were found in 70 patients （79.55 % ）, 36 patients （40.91%） were detected and unstable carotid atherosclerotic plaques were found, and most of which stayed in the side of cerebral infarction. The component ratio of unstable carotid atherosclerotic plaques in the side of cerebral infarction was higher than that of non-infarction. ②Serum hs-CRP level in the unstable atherosclerotic plaques group was higher than that in the stable plaques group, nonplque group and control group. People with abnormal increased serum hs-CRP level have higher risk of existing unstable atherosclerotic carotid plaques than that in the normal subjects found through by risk analysis（OR = 2.05 95% CI 1. 419- 7. 302）. Logistic regression analysis showed that the serum hs-CRP level was related to unstable atherosclerotic carotid plaques （P 〈 0.05）. Conclusions ①The important relationship existed between unstable carotid atherosclerotic plaques and cerebral infarction. ②hs-CRP maybe an in dependent serum marker of unstable carotid at herosclerosclerotic plaques.