脑梗死患者血浆纤维蛋白原水平与颈动脉粥样硬化的关系

Relationship between the level of fibrinogen and carotid atherosclerosis in patients with cerebral infarction

目的探讨脑梗死患者血浆纤维蛋白原（fibrinogen，Fg）水平与颈动脉粥样硬化（carotid atherosclerosis，CAS）的关系及相关危险因素对颈动脉粥样硬化发生、发展的作用。方法选择脑梗死患者508例。应用彩色多普勒超声检查患者颈总动脉（common carotid artery，CCA）、颈内动脉（Internal carotid artery，ICA）颅外段及颈总动脉分叉处内-中膜厚度（Intima—medial Thickness，IMT）。评定标准：颈动脉IMT〉0．9mm或（和）颈动脉斑块定义为CAS。入院后24h内抽取空腹静脉血送检，测定Fg水平及其他生化指标，记录高血压病、糖尿病、吸烟等病史，运用Logistic回归分析相关危险因素对颈动脉粥样硬化的作用大小。结果按Fg水平分组（Fg≤3g／L组、Fg〉3g／L组），Logistic回归分析显示Fg〉3g／L组的危险度为2．04，年龄、Fg水平、高血压病史及吸烟史对CAS有影响，差异有统计学意义（P〈0．05），其中Fg与CAS的相关性最强。结论Fg水平与脑梗死患者CAS的发展密切相关，其作用可能强于其他的传统危险因素。

Objective To investigate the association between the level of fibrinogen and carotid atheroselerosis （CAS） and the effect of relevant risk factors on CAS. Methods Carotid intima--media thickness （IMT） was measured using color Doppler ultrasonography in 508 patients with cerebral infarc- tion. According to the results of ultrasonography, the patients were divided into two groups： normal （IMT≤0.9 mm）, and carotid atherosclerosis （IMT〉0.9 mm and plaque）. The plasma fibrinogen and other biochemical markers were also detected. The history of hypertension, diabetes, and smoking were also recorded. Results According to the level of fibrinogen, patients were divided into two groups： 3 g/L group and 〉3 g/L group. Logistic regression showed that the rate of 〉3 g/L group was 2.04. There were significant differences in age, fibrinogen, hypertension, and smoking between the normal-- carotid group and the carotid atherosclerosis group. Logistic regression showed that age, fibrinogen, hy- pertension, and smoking had significant influence on the CAS, with the highest risk factor being the fi- brinogen. Plasma fibrinogen was higher in lacunar infarction patients. Conclusions In patients with cere- bral infarction, the elevated plasma fibrinogen was significantly correlated with CAS. Therefore, fibrino- gen might play more important role than other traditional risk factors.