颈动脉粥样硬化斑块及其相关因素与脑梗死的关系

Relationship among Carotid Atherosclerotic Plaque and Its Related Factors and Cerebral Infarction

目的探讨颈动脉粥样硬化(CAS)斑块及血脂、血糖(BG)、纤维蛋白原(Fbg)水平与脑梗死的关系。方法对2007年11月-2008年12月入院的91例脑梗死患者,应用彩色多普勒检测其颈动脉内-中膜厚度(IMT)、斑块数和性状,同时检测血脂、血糖、纤维蛋白原水平,并与正常对照组比较。结果①与正常对照组比较,脑梗死组IMT明显增厚、CAS斑块检出率、软斑百分比明显增高(P<0.05)。②血清总胆固醇(TC)、低密度脂蛋白(LDL)、BG及Fbg水平脑梗死组明显高于正常对照组(P<0.05);脑梗死有斑块亚组明显高于无斑块亚组(P<0.05)。③脑梗死组IMT与TC、LDL、BG、Fbg水平呈正相关(r分别为0.32、0.34、0.30、0.36,P<0.05)。结论脑梗死患者IMT增厚,CAS斑块及软斑发生率高。BG、TC、LDL及Fbg水平增高是脑梗死及CAS斑块发生的危险因素。

Objective To investigate the relationship between carotid atherosclerosis (CAS) plaque and its related factors and cerebral infarction (CI).Methods The 91 patients with CI were detected by Color Doppler, and their levels of plasma lipid, blood glucose (BG) and fibrinogen (Fbg) were evaluated, and compared with normal control (NC) group.Results (1)Compared with NC group, intima-media thickness (IMT), prevalence of CAS plaque, the rates of soft plaque in CI group were significantly higher (all P<0.05). (2)The level of total cholesterol (TC), low density lipoprotein (LDL), BG and Fbg In CI group were significantly higher than those in NC group (P<0.05), and in CI with plaque subgroup were significantly higher than those in CI without plaque subgroup (P<0.05). (3)The prevalence of CAS plaque and IMT were positively correlative with the levels of TC, LDL, BG, Fbg (r=0.32, 0.34, 0.30, 0.36 respectively, P<0.05).Conclusion CI patients show increased IMT and high prevalence of CAS plaque. Hyperglycemia, high levels of TC, LDL and Fbg are risk factors of CAS plaque.