炎症因子对缺血性脑卒中患者颈动脉易损性斑块的影响

EFFECTS OF INFLAMMATORY FACTOR ON CEREBRAL ISCHEMIC STROKE IN PATIENTS WITH CAROTID ARTERY PLAQUE VULNERABILITY

目的探讨缺血性脑卒中伴颈动脉易损性斑块的临床特点以及与炎症因子的关系。方法连续收集缺血性脑卒中患者398例,进行CT血管成像联合颈动脉超声检查,分析斑块性质、形态,根据患者发生颈动脉斑块的性质将其分为易损性斑块组152例,非易损性斑块组246例,对二组采集研究对象的基线资料和疾病史进行单因素分析和多因素Logistic回归分析。结果二组比较,易损性斑块组患者年龄、血同型半胱氨酸、高敏C反应蛋白、白细胞、中性粒细胞、嗜酸性粒细胞、纤维蛋白原水平偏高、吸烟所占比例明显升高,HDL-C水平明显降低,差异有统计学意义。高敏C反应蛋白、白细胞、中性粒细胞、嗜酸性粒细胞、纤维蛋白原与缺血性脑卒中患者颈动脉易损性斑块发生相关。高敏C反应蛋白对易损斑块的敏感性,特异性最高。结论炎症因子水平升高是缺血性脑卒中伴颈动脉易损性斑块发生的重要危险因素。

Objective To explore the clinical features as well as the relationship with the levels of inflamma- tory factors in patients with ischemic stroke associated with carotid vulnerable plaque. Methods Continu- ously collected 398 cases of ischemic stroke as the subjects, who received a test of CT angiography com- bined carotid ultrasound. All subjects were analyzed the property and shape of plaque, then according to it divided the patients with carotid artery plaque into the vulnerability of the plaque group（n = 152） and the unvulnerability group（n = 246）. Univariate analysis and multivariate logistic regression analysis were per- formed. Results In the vulnerability plaque group, age, homocysteine, high- sensitivity C- reactive pro- tein, white blood cells, neutrophils, eosinophils, and fibrinogen all appeared high levels; Smokers accoun- ted for a large proportion of; HDL- C levels were significantly lower, all the differences were statistically significant. High- sensitivity C- reactive protein, white blood cells, neutrophils, eosinophils, and fibrino- gen were associated with plaque vulnerability in carotid artery among patients with ischemic stroke. High- sensitivity C- reactive protein had the highest specificity and sensitivity on vulnerable plaque. Conclusion Elevated levels of inflammatory cytokines are important risk of ischemic cerebral stroke in patients with ca- rotid artery plaque vulnerability factors.