急性脑梗死的颈动脉内中膜厚度与血清高敏C反应蛋白、纤维蛋白原和同型半胱氨酸关系

Correlation of high-sensitive C-reactive protein,fibrinogen,homocysteine and intima-media thickness in patients with acute cerebral infarction

目的观察急性脑梗死的颈动脉粥样硬化与血清高敏C反应蛋白(hsCRP),纤维蛋白原(Fbg)和同型半胱氨酸(Hcy)关系。方法在我院就诊住院的急性脑梗死患者165例,和同期在我院健康体检患者20例为健康对照组。观察急性脑梗死和健康对照组的Fbg,Hcy和hsCRP水平变化,观察Fbg,Hcy和hsCRP水平与颈动脉粥样硬化及颈动脉斑块严重程度的关系。结果急性脑梗死组的hsCRP,Fbg,Hcy和颈动脉内膜-中膜厚度(IMT)水平较健康对照组明显升高,(15.8±2.94)mg/L vs(2.74±0.96)mg/L,(4.67±1.18)g/L vs(2.36±0.82)g/L,(24.3±6.83)μmol/L vs(6.83±1.83)μmol/L vs(1.37±0.32)mm vs(0.76±0.16)mm(P<0.01)。急性脑梗死患者动脉粥样硬化根据IMT划分为:IMT<1.0mm为26例,1.0mm≤IMT<1.2mm为43例和IMT≥1.2mm为96例。随着颈动脉粥样硬化严重程度的加重,急性脑梗死患者的hsCRP,Fbg和Hcy水平出现明显升高,(7.98±1.76)mg/L vs(12.87±2.87)mg/L vs(19.28±3.13)mg/L,Fbg(2.45±0.97)g/L vs(4.58±1.04)g/L vs(5.31±1.25)g/L and Hcy(10.87±2.76)μmol/L vs(22.94±6.28)μmol/L vs(28.68±7.03)μmol/L(P<0.05或<0.01)。急性脑梗死组根据动脉粥样硬化斑块形成的严重程度分为Ⅰ级29例,Ⅱ级35例和Ⅲ级32例。随着急性脑梗死颈动脉斑块严重程度的增加,血清hsCRP(14.65±2.97)mg/L vs(19.43±3.26)mg/L vs(23.31±3.02)mg/L,Fbg(4.41±1.18)g/L vs(5.33±1.21)g/L vs(6.10±1.32)g/L和Hcy(22.87±5.87)μmol/L vs(28.47±6.92)μmol/L vs(34.18±7.12)μmol/L水平出现明显升高(P<0.05或<0.01)。结论急性脑梗死患者血清hsCRP,Fbg和Hcy水平高于健康对照组,与颈动脉粥样硬化和动脉斑块具有明显的相关性。

Objective To observe the correlation of high sensitive C-reactive protein（hsCRP） ,fibrinogen（Fbg）, homocysteine（Hcy） and atherosclerosis in patients with acute cerebral infarction. Methods The study involved 165 patients with acute cerebral infarction who were treated in the hospital,as acute cerebral infarction group, 20 healthy persons also were observed at the same period. The levels of Fbg, Hcy and hsCRP were observed in both acute cerebral infarction and healthy control groups. Their relationship,carotid atherosclerosis severity and atherosclerotic plaque were also observed in each group. Results The levels of hsCRP, Fbg, Hcy and IMT were significantly higher in acute cerebral infarction group than those in healthy control group, （ 15.8 ± 2.94） mg/L vs （ 2.74± 0.96 ） mg/L, （4.67 ± 1.18） g/L vs （2.36±0.82） g/L,（24±6.83） μmol/L vs （6.83±1.83） μmol/L and （1.37..0.32） mm vs （0.76!0.16） mm（ P 〈 0.01）. According to IMT of atherosclerosis, 165 patients with acute cerebral infarction were divided into：26 cases for IMT〈I. 0 ram,43 cases for 1.0 mm≤IMT〈1. 2 mm and 96 cases for IMT≥ 2 mm. As the severity of carotid atherosclerosis increased in acute cerebral infarction group, the levels of hsCRP, Fbg and Hey were significantly higher, （7.98±1.76） mg/L vs （12.87±2.87） mg/L vs （19.28±3.13） mg/L,Fbg （2.45±0.97） g/L vs （4.58±1.04） g/L vs （5.31±1.25） g/L and Hey（10.87±2.76） ~mol/L vs （22. 94±6.28） ~mol/L vs （28.68±7.03） gmol/L （ P 〈 0.05 or 〈0.01）. According to the severity of atherosclerotic plaque acute cerebral infarction group,were divided into 29 cases in grade I ,35 cases in grade ]1 and 32 cases in grade 1]I. As the severity of carotid plaque increased in acute cerebral infarction,the levels of hsCRP, Fbg and Hcy were significantly higher, （14.65±2.97） mg/L vs （19.43± 3.26） mg/L vs （23.31±3.02） mg/L,（4. 41±1.18） g/L vs （5.33±1.21） g/L vs （6.10±1.32） g/L and （22.87± 5.87） μmol/L vs （28.47±6.92） μmol/L vs （34.18±7.12） μmol/L（ P 〈0.05 or 〈0.01）. Conclusion The serum levels hsCRP,Fbg and Hey were higher in acute cerebral infarction group than those in healthy control group,and their levels have obvious relevance to the severity of carotid atherosclerosis and carotid plaque.