急性脑梗死患者血小板白细胞聚集体与动脉粥样硬化的关系

Association between platelet-leukocyte aggregation and atherosclerosis in acute ischemic stroke patients

目的探讨急性脑梗死患者血清血小板白细胞聚集体与动脉粥样硬化斑块的关系。方法选择脑梗死患者110例,根据高分辨率MRI对颈动脉和大脑中动脉评估结果分为易损斑块组24例,稳定斑块组56例,无斑块组30例,另选择健康体检者30例(对照组)。比较各组血小板白细胞聚集体、血小板单核细胞聚集体、血小板中性粒细胞聚集体、血小板淋巴细胞聚集体水平。结果易损斑块组、稳定斑块组、无斑块组血清血小板白细胞聚集体、血小板单核细胞聚集体、血小板粒细胞聚集体、血小板淋巴细胞聚集体水平明显高于对照组,差异有统计学意义(P<0.05)。易损斑块组和稳定斑块组血清血小板白细胞聚集体、血小板单核细胞聚集体水平明显高于无斑块组,差异有统计学意义(P<0.05)。与稳定斑块组比较,易损斑块组血小板单核细胞聚集体水平明显升高,差异有统计学意义[(31.34±6.18)%vs(24.67±5.34)%,P<0.05]。结论血小板白细胞聚集体与动脉粥样硬化斑块有关,而血小板单核细胞聚集体与斑块易损性密切相关,可作为斑块易损性指标。

Objective To study the association between platelet-leukocyte aggregation and athero- sclerosis in acute ischemic stroke （AIS） patients. Methods One hundred and ten AIS patients were divided into vulnerable carotid plaque group （n ： 24）, stable carotid plaque group （n ： 56） and no carotid plaque group （n=30）. Thirty subjects undergoing physical examination served as a control group. The incidence of platelet-leukocyte aggregation, platelet-monocyte aggregation, platelet-neutrophil aggregation,and platelet-lymphocyte aggregation in different groups was compared. Results The incidence of platelet-leukocyte aggregation, platelet-monocyte aggregation, platelet-neutrophil aggregation, and platelet-lymphocyte aggregation was significantly higher in vulnerable carotid plaque group, stable carotid plaque group and no carotid plaque group than in control group （P〈0.05）. The incidence of platelet-leukocyte aggregation and platelet-monocyte aggregation was significantly higher in vulnerable carotid plaque group and stable carotid plaque group than in no carotid plaque group （P〈0.05）. The incidence of platelet-monocyte aggregation was significantly higher in vulnerable carotid plaque group than in stable carotid plaque group （31.34%±6.18% vs 24.67%±5.34%,P〈0.05）.Conclusion Platelet-leukocyte aggregation is related with atherosclerosis whereas platelet-monocyte aggregation is closely related with vulnerable carotid plaques and can thus be used as a marker for vulnerable carotid plaques.