伴颈动脉粥样硬化短暂性脑缺血发作患者血浆组织因子变化的意义

Significance of changes of plasma tissue factor in TIA patients with carotid atherosclerosis

目的探讨短暂性脑缺血发作(TIA)患者颈动脉病变与血浆组织因子(TF)水平的关系及临床意义。方法选择TIA患者58例,根据彩色多普勒超声将不稳定性斑块的22例为A组,稳定性斑块的19例为B组,无斑块的17例为C组,用ELISA法测定3组患者血浆TF水平。53例完成3年随访,根据TF水平分为高水平组22例,低水平组31例,比较2组患者3年时脑卒中风险。结果 A组血浆TF水平明显高于B组和C组(P<0.05,P<0.01),B组血浆TF水平明显高于C组(P<0.05);血浆TF水平与管腔狭窄率呈正相关(r=0.356,P<0.05);高水平组脑梗死发生率和反复TIA发作比例明显高于低水平组(P<0.05,P<0.01)。结论伴颈动脉粥样硬化斑块的TIA患者血浆TF水平增高可预测脑梗死的发生,其可作为TIA患者预后评价指标。

Objective To explore the change of plasma tissue factor（TF） in TIA patients with carotid atherosclerosis and clinical significance. Methods The carotid artery was examined with col- or Doppler in 58 cases of TIA. Of them,22 with unstable atherosclerotic plaque were selected as group A, 19 with stable atherosclerotic plaque were group B,and 17 with no plaque were group C. The level of TF was detected in all the subjects with ELISA. The incidences of cerebral infarction and the risk of stroke were compared within 3 years in these patients. Results The level of plas- ma TF in cases of group A was higher than that in group B and group C （P〈0.05 ,P 〈 0.01）, and it was higher in gourp B compared with group C （P 〈 0.05）. It increased with increase in degree of stenosis and was positively correlated with the rate of stenosis （r = 0. 356, P 〈0.05）. The incidence of cerebral infarction was higher in cases with higher level of TF than in cases with lower level of TF （P 〈 0.01）. Conclusion The increase of plasma TF in TIA patients with carotid atherosclerotic plaque may forecast the occurrence of cerebral infarction, and it may be regarded as one of the predictors of prognosis of TIA patients.