短暂性脑缺血发作的相关危险因素及与颈动脉粥样硬化斑块的相关性

Correlation of related risk factors and carotid atherosclerosis in patients with transient ischemic attack

目的探讨短暂性脑缺血发作（TIA）的相关危险因素及与颈动脉粥样硬化斑块的关系。方法收集2009-08~2010-03徐州医学院附属医院TIA病人62例和同期健康体检者40例,测定血糖、总胆固醇（total cholesterol,TC）、甘油三酯（triglyceride,TG）、高密度脂蛋白（high-density lipoprotein,HDL）、低密度脂蛋白（low-density lipoprotein-cholesterol,LDL）、纤维蛋白原（fibrinogen,FIB）、超敏C反应蛋白（high sensitive C-reactive protein,hs-CRP）、同型半胱氨酸（homocysteine,HCY）。应用颈部动脉血管彩超（由附院彩超室提供）进行颈部动脉内膜中层厚度和斑块检测。结果 TIA组总胆固醇、低密度脂蛋白、纤维蛋白原、超敏C反应蛋白、同型半胱氨酸均较高,差异有统计学意义。2组间高密度脂蛋白、甘油三酯、血糖无显著差异。TIA组和对照组颈动脉粥样硬化斑块分型检测情况差别具有统计学意义。结论 TIA患者的动脉粥样硬化斑块发生率及颈动脉内-中膜厚度（IMT）较高,2组斑块的多发部位无显著差异。总胆固醇、低密度脂蛋白、纤维蛋白原、超敏C反应蛋白、同型半胱氨酸是与TIA相关的独立危险因素。

Objective To explore the clinical risk factors of transient ischemic attack（TIA）and the relationship with carotid atherosclerosis.Methods Total 62 TIA patients from August in 2009 to March in 2010 in Xuzhou Medical College Affiliated Hospital and 40 health examined people from physical examination center were collected.The blood glucose,total cholesterol（TC）,triglyceride（TG）,high-density lipoprotein（HDL）,low density lipoprotein（LDL）,fibrinogen（FIB）,high sensitive C-reactive protein（hs-CRP）,and homocysteine（HCY） were examined.Arterial vascular ultrasound（ultrasonography room provided by the affiliated hospital） was used in carotid artery intima-media thickness and plaque.Results In comparison with those in the control group,the rates of abnormalities of cholesterol,low density lipoprotein,fibrinogen,high sensitive C-reactive protein,and homocysteine were higher in TIA group,with a significant difference between the two groups.However,there was no statistical difference in high-density lipoprotein,triglyceride,and blood glucose.The carotid atherosclerosis genotyping conditions in the TIA group and control group had a statistical significance.Conclusion The incidences of carotid atherosclerosis and carotid intima-media thickness（IMT） in TIA patients are high.The plaques in the two groups have no significant difference.The abnormalities of cholesterol,low density lipoprotein,fibrinogen,high sensitive C-reactive protein,and homocysteine are independent risk factors for the short term prognosis of TIA.