急性脑梗死与颈动脉斑块、超敏C反应蛋白和P-选择素水平的相关性探讨

Study of the relationship between carotid plaque, hypersensitive C-reactive protein and P-selectin in acute cerebral infarction

目的:探讨颈动脉斑块性质、超敏C反应蛋白和P-选择素与急性脑梗死的关系。方法:应用彩色多普勒超声仪检测急性脑梗死患者(A组,n=42)及年龄相近的无症状颈动脉斑块患者(B组,n=40)颈动脉内膜中膜厚度(IMT)、斑块类型,同时测定血清的超敏C反应蛋白和P-选择素水平。结果:A组与B组颈动脉IMT均明显增厚,2组颈动脉狭窄率差异无统计学意义。A组斑块以软斑为主,B组以硬斑为主。A组hsCRP水平高于B组(P<0.05);颈动脉狭窄程度越高,血清hsCRP水平越高;A组P-选择素水平高于B组(P<0.05);软斑患者hsCRP和P-选择素水平明显高于非软斑组(P<0.01),且软斑组hsCRP水平与P-选择素水平呈正相关(r=0.66,P<0.01)。结论:斑块软化破裂是急性脑梗死的重要危险因素,超敏C反应蛋白和P-选择素是斑块不稳定的特异性指标。

Objective： To investigate the relationship between carotid plaque, hypersensitive C-reactive protein （hsCRP） and P-selectin in acute cerebral infarction. Methods： The intima-media thickness （IMT） , plaque type of carotid artery were examined by color Doppler in 42 patients with acute cerebral infarction （ group A） and 40 asymptomatie patients with carotid plaque （ group B） , and the levels of hsCRP and P-selectin were measured as well. Results ： The [MT were ob- viously thicker both in group A and group B, and the difference was not statistically significant. Soft plaques were predomi- nant in group A whi｜e hard plaques were major portion in group B. Compared with the group B, the levels of hsCRP were significantly higher in group A （P 〈 0.05 ）. The more severe the carotid stenosis, the higher the serum level of hsCRP. The plasma P-slectin level were significantly higher in group A than that in group B （ P 〈 0.05 ）. hsCRP and P-selectin were significantly higher in patients with soft plaque than those with hard plaque （P 〈 O. O1 ）. A positive correlation between the level of hsCRP and P-selectin were found in soft plaque group （ r = 0.66, P 〈 0.01 ）. Conclusion ： Soft plaque is an impor- tant risk factor of acute cerebral infraction hsCRP and P-selectin seems to be the specific indexes of unstable plaque.