超声斑块稳定性、颈总动脉内中膜厚度和血清C-反应蛋白与脑梗死相关

Relationship among Ultrasound Plaque Stability,Intima - medial Thickness,Serum C - reaction Protein and Cerebral Infarction

目的：观察脑梗死患者颈动脉超声斑块稳定性、颈总动脉内中膜厚度（IMT）和血清 C -反应蛋白（CRP）水平，阐明它们与脑梗死发生的关系。方法选取我院神经内科收治的脑梗死连续性患者112例作为实验组，同期体检中心的连续性健康体检者93例作为对照组，观察并评估颈动脉斑块的稳定性，测量颈动脉血管内中膜厚度（IMT）、血清 CRP 水平及其相关性。结果①实验组的斑块发生率76.8％（86例），IMT （1.24±0.31）mm，血清 CRP（5.57±2.43）mg/ L，对照组的斑块发生率16.1％（15例），IMT（0.59±0.06）mm，血清 CRP（2.14±0.85）mg/ L，实验组三项指标均高于对照组，有统计学意义（P ﹤0.05）；②在86例实验组斑块患者中，稳定斑块者19例（22.1％），不稳定斑块者67例（77.9％），脑梗死患者中不稳定性斑块的发生率比稳定性斑块高，差异有统计学意义（P ﹤0.05）；③稳定斑块组患者的 IMT 为（0.87±0.11）mm，血清 CRP 为（4.45±1.82）mg/ L，不稳定斑块组患者的 IMT 为（1.21±0.29）mm，血清 CRP 为（8.03±2.77）mg/ L，后者的CRP 水平和 IMT 值均明显高于前者（ P ﹤0.05）；④实验组 CRP 水平和 IMT 呈正相关，相关系数 r ＝0.73，有统计学意义（P ﹤0.05），对照组 CRP 水平和 IMT 呈正相关，相关系数 r ＝0.67，有统计学意义（P ﹤0.05），两组混合后 CRP 水平和 IMT 呈正相关，相关系数 r ＝0.69，有统计学意义（P ﹤0.05）。结论①脑梗死患者的颈动脉斑块发生率高于健康人群；②在有斑块的脑梗死患者中，不稳定性斑块发生率显著高于稳定性斑块；③不稳定斑块患者的 IMT 和 CRP 显著高于稳定性斑块患者。结果提示颈动脉斑块的不稳定性、IMT 增厚和 CRP 升高均与脑梗死的发生相关，对脑梗死的预测可能具有重要意义。

Objective To investigate the relationship among carotid plaque stability,intima - medial thickness （IMT）,serum C - reaction protein（CRP）and cerebral infarction. Methods 112 hospitalized patients with cerebral infarction were taken as group I,while 93 healthy cases as group II. Carotid plaque stability,IMT and CRP were meas-ured and evaluated. Results ①Incidence of plaque was 76. 8% with IMT（1. 24 ± 0. 31）mm and serum CRP（2. 14 ± 0. 85）mg/ L in group I. Incidence of plaque,IMT and CRP were 16. 1% ,（0. 59 ± 0. 06）mm and（2. 14 ± 0. 85） mg/ L respectively in group II. There were significant differences between the two groups（P ﹤ 0. 05）. ②There were 19 patients with stable plaque（22. 1% ）in 86 patients in group I. The incidence of unstable plaque was significantly high-er than stable plaque in patients with cerebral infarction（P ﹤ 0. 05）. ③IMT was（0. 87 ± 0. 11）mm with CRP（4. 45 ± 1. 82）mg/ L in for patients with stable plaque. IMT was（1. 21 ± 0. 29）mm with CRP（8. 03 ± 2. 77）mg/ L in patients with unstable plaque（P ﹤ 0. 05）. ④CRP was positively correlated with IMT in group I（r = 0. 73,P ﹤ 0. 05）. CRP was positively correlated with IMT in group II（r = 0. 67,P ﹤ 0. 05）. The total CRP was positively correlated with total IMT （r = 0. 69,P ﹤ 0. 05）. Conclusion ①The incidence of carotid plaque is higher in patients with cerebral infarction.②The incidence of unstable plaque is significantly higher than stable plaque in patients with cerebral infarction. ③IMT and CRP are higher in patients with unstable plaque. There are relationships among carotid plaque stability,IMT, CRP and cerebral infarction,which may have predictive significance for cerebral infarction.