脑梗死患者颈动脉粥样硬化斑块的相关因素分析

An analysis on the Risk Factors of Carotid Artery Atherosclerotic Plaques in Cerebral Infarction Patients

目的:探讨脑梗死患者颈动脉粥样硬化斑块形成及其稳定性的相关影响因素。方法:应用彩色多普勒超声检测脑梗死患者126例及正常对照者61例颈动脉斑块形成情况;根据超声检查结果将126例脑梗死患者分为有斑块组102例,无斑块组24例,将102例有斑块者分为稳定斑块亚组35例及不稳定斑块亚组67例;比较各组脑梗死危险因素,测量并比较各组总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)、脂蛋白(a)(Lp(a))、血糖(BG)及纤维蛋白原(FIB)浓度。结果:脑梗死患者颈动脉粥样硬化斑块发生率80.9%,显著高于正常对照者29.5%(P<0.01);与无斑块组相比,有斑块组患者高龄、吸烟、有高血压病及糖尿病史,血TC、Lp(a)、Apo B、FIB、LDL-C及BG浓度较高(P<0.01,P<0.05);不稳定斑块亚组FIB浓度高于稳定斑块亚组(P<0.05)。结论:颈动脉粥样硬化斑块与脑梗死密切相关,颈动脉粥样硬化斑块的形成与年龄、高血压病、糖尿病、血脂异常、吸烟、高纤维蛋白原等因素有关,纤维蛋白原与斑块稳定性有关。

Objective：To explore the risk factors for carotid artery atherosclerotic plaques in cerebral infarction patients.Methods： Color doppler ultrasound scanner was used to detect the plaques of the carotid arteries in patients with cerebral infarction（n=126） and normal controls（n=61）.According to the doppler ultrasound scanning,the patients were divided into plaque（＋） group（n=102） and plaque（-） group（n=24）.The patients in the plaque（＋） group were further divided into stable plaque（n=35） and unstable plaque subgroups（n=67）.The physical data and the 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-a（Lp（a））,fibrinogen（FIB） and blood glucose（BG） were measured,and compared between the groups.Results： Carotid atherosclerotic artery plaques were detected in 80.9% of the patients,which was significantly higher than that in the normal controls（P0.01）.When compared with those in plaque（-） group,those patients were much older.Smoking,hypertension,diabetes,higher concentrations of TC,Lp（a）,ApoB,FIB,LDL-C,and BG were more frequently found in the plaque（＋） group.The FIB concentrations of patients in the unstable plaque subgroup was much higher that in the stable plaque subgroup（P0.05）.Conclusion： Carotid atherosclerotic plaques were the risk factor for cerebral infarction.Old age,smoking,hypertention,diabetes mellitus,lipoidosis,and high fibrinogen are the risk factors for carotid atherosclerotic plaques.High concentration of fibrinogen affects stability of the plaques.