脑梗死患者颈动脉粥样硬化的危险因素分析

Study on the risk factors of carotid artery atherosclerosis in cerebral infarction patients

目的探讨脑梗死患者颈动脉粥样硬化程度与血脂、纤维蛋白原、血糖、血尿酸及C反应蛋白的关系。方法将122例脑梗死患者按颈动脉硬化程度分为内膜中膜增厚组、斑块形成组和管腔狭窄组,分别测定其与56例对照组的总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A、载脂蛋白B、脂蛋白(a)、纤维蛋白原、血糖、血尿酸及C反应蛋白水平,观察颈动脉粥样硬化程度与血脂、纤维蛋白原、血糖、血尿酸及C反应蛋白的关系。结果斑块形成组和管腔狭窄组三酰甘油、低密度脂蛋白胆固醇、载脂蛋白B、纤维蛋白原、血糖、血尿酸及C反应蛋白水平显著高于内膜中膜增厚组和对照组(P<0.05)。内膜中膜增厚组三酰甘油、低密度脂蛋白胆固醇、载脂蛋白B、纤维蛋白原、血糖、血尿酸及C反应蛋白水平显著高于对照组(P<0.05)。Logistic多元回归分析发现,颈动脉粥样硬化程度与低密度脂蛋白胆固醇、脂蛋白(a)、纤维蛋白原、血糖、血尿酸呈显著正相关(P<0.05～0.01)。结论低密度脂蛋白胆固醇、脂蛋白(a)、纤维蛋白原、血糖、血尿酸是颈动脉粥样硬化的独立危险因素。及时检测脑梗死患者血脂、纤维蛋白原、血糖、血尿酸、C反应蛋白和颈动脉粥样硬化情况,评价病变程度,对疾病的早期防治具有重要的价值。

Objective To study the relationship among blood-lipid,fibrinogen（FIB）,fasting blood glucose（FBG）,blood uric acid（UA）,C-reactive protein（CRP）and the degree of carotid artery atherosclerosis in the patients with cerebral infarction.Methods 122 patients with cerebral infarction were divided into intima-media thickness group,plaque development group and vessel stenosis group.Concentration of total cholesterol（TC）,triglycerides（TG）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,apolipoprotein A（ApoA）,apolipoprotein B（ApoB）,lipoprotein-aLp（a）,FIB,FBG,blood UA and CRP were measured in 122 patients and 56 cases of control group.The relationship between the degree of carotid artery atherosclerosis and the abovementioned parameters was observed.Results The concentration of TG,LDL-C,ApoB,FIB,FBG,blood UA and CRP were significantly higher in plaque development group and vessel stenosis group than in intima-media thickness group and control group（P〈0.05）,and they were obviously higher in intima-media thickness group than in control group（P〈0.05）.The result of Logistic regression analysis indicated there were positive correlation among LDL-C,Lp（a）,FIB,FBG,blood UA and carotid artery atherosclerosis（P〈0.05～0.01）.Conclusion LDL-C,Lp（a）,FIB,FBG and blood UA were the independent risk factors of carotid artery atherosclerosis.The concentration of blood lipid,FIB,FBG,blood UA and CRP and the degree of carotid artery atherosclerosis in patients with cerebral infarction should be measured in time,the severity of disease should be evaluated early,all of these are of importance for the clinical prevention and treatment of disease.