影响颈动脉狭窄预后的相关因素分析

Analysis on the related factorsinfluencing the prognosis of carotid artery stenosis

目的研究不同颈动脉狭窄患者脑血管储备情况及血管炎性标志物血清超敏C反应蛋白(hs-CRP)水平,探讨二者对评估颈动脉狭窄患者病情严重程度及预后的作用。方法采用经颅多普勒-CO,实验评价脑血管储备情况,采用散射比浊法检测血清hs-CRP水平。结果颈动脉狭窄患者的BHI水平均低于对照组,无症状组BHI均高于相同狭窄程度有症状组,轻中度颈动脉狭窄患者BHI无显著性差异,重度狭窄组BHI低于轻、中度狭窄组。颈动脉狭窄患者血清hs-CRP水平均高于对照组,患者随狭窄程度加重hs-CRP水平逐渐增高。症状性颈动脉狭窄患者随访2年内有9例发生了缺血性卒中,BHI水平均在1.25以下,hs-CRP水平均高于7.9 mg/L,高于未发生脑卒中的患者(P<0.01);无症状组中6例发生卒中,BHI水平均在1.35以下,hs-CRP水平均高于8.7mg/L,高于无症状组中未发生脑卒中的患者(P<0.01)。BHI与hs-CRP能够作为卒中事件发生的独立危险因素。结论脑血管储备及血管炎性标志物测定为判断颈动脉狭窄患者病情严重程度及预后具有一定的价值。

Objective To observecerebral vascular reserve station and the level of vascular inflammatory markers hs- CRP of different patients withcarotid stenosis,to explore the predict effect on evaluating the severity of the disease in patients with carotid artery stenosis.Methods Using trans- cranial Doppler（TCD）- C02 experiment to evaluatethe cerebrovascular reserve condition,scattering turbidimetric method was used to detect serum hs- CRP levels.Results BHI levels of symptomatic and asymptomatic group were lower than the control group,the degree of BHI in asymptomatic group was higher than that in the symptomatic group.The difference of BHI level between moderate and mild stenosis group without statistical significant and BHI in severe stenosis group was lower than the mild and moderate stenosis group.The hs- CRP levels in the symptomatic and asymptomatic group were higher than the control group.The hs- CRP levels increased gradually as the narrow degree aggravating.During the two year following up progress 9 cases of cerebral apoplexyoccurred in symptoms group,BHI levels were lower than 1.25 and the levels of hs- CRPwere higher than 7.9 mg/L,which higher than that of those patients without stroke in symptomatic group（P 〈 0.01）.Asymptomatic group had 6 cases of cerebral apoplexy,6 cases of BHI level below 1.35.The hs- CRP levels were higher than 8.7 mg/L,which higher than the patientswithout stroke inasymptomaticgroup（P 〈0.01）.BHI and hs- CRP can be used as an independent risk factor for stroke events.Conclusions Cerebrovascular reserve and vascular inflammatory markers level can effectively evaluate severity and prognosis of patients with carotid artery stenosis disease.