再发性缺血性脑卒中患者颈动脉易损斑块对脑血管事件的影响分析

Impact analysis of recurrent cerebral arterial thrombosis patients' carotid vulnerable plaques condition to cerebrovascular events

目的分析再发性缺血性脑卒中(cerebral arterial thrombosis,CAT)患者颈动脉易损斑块对脑血管事件的影响。方法回顾性分析2008年6月至2012年6月于本院住院治疗的120例再发性CAT患者的临床资料。依照颈动脉超声及颈部CT结果将入选患者分为观察组(伴易损斑块,40例)与对照组(非易损斑块,80例)。观察两组患者入院时超敏C反应蛋白(hs-CRP)、纤维蛋白原、糖化血红蛋白(Hb Alc)水平、血压、颈动脉易损斑块厚度及180天内复发脑血管事件发生情况。结果观察组患者年龄、hs-CRP、纤维蛋白原、Hb Alc水平及高血压患者所占比例均显著高于对照组,糖尿病患者所占比例和高密度脂蛋白胆固醇(HDL-C)水平均显著低于对照组(P<0.05)。观察组患者入院后7、14及30天脑血管事件发生率均显著高于对照组(P<0.05)。观察组患者各时间段复发率和入院后30天死亡率均显著高于对照组,且重度及以上斑块患者的复发率及死亡率均显著高于轻、中度斑块患者(P<0.05);对照组患者重度及以上斑块患者的复发率与轻、中度斑块患者比较差异无显著性(P>0.05);对照组重度及以上斑块患者的死亡率明显高于轻、中度斑块患者(P<0.05)。结论再发性CAT患者颈动脉易损斑块可较大程度地影响脑血管事件发生,临床应引起重视。

Objective To analyze the impact of recurrent cerebral arterial thrombosis（CAT） patients, with carotid vulnerable plaque condition to cerebrovascular events. Method The data of 120 patients with recurrent CAT in our hospital were analyzed retrospectively from June 2008 to June 2012 and they were divided into 40 cases of vulnerable plaques as observation group, 80 cases of no vulnerable plaques as control group by according to the results of carotid ultrasound and neck CT diagnostic. Observed the levels of hsCRP, fibrinogen, glycosylated hemoglobin, blood pressure, carotid plaque thickness on admission, and the recurrence of cerebral vascular events within 180 days. Result The age, hs-CRP, fibrinogen, fasting glucose and the proportion of high blood pressure for the patients of observation group were significantly higher than control group and the proportion of the diabetes, the level of HDL-C was significantly lower than control group（P〈0.05）. The incidence of cerebral vascular events for 7 day, 14 days and 30 days of observation group were significantly higher than control group（P〈0.05）. The recurrence rate and the mortality during the perioperative phase of observation group were higher than control group, the recurrence rate and mortality of heavy and above plaque were significantly higher than light, moderate ones（P〈0.05）. There was no significant difference on the rate of relapse for control group of slightly-moderately, light-medium（P〉0.05）. The rate of mortality for control group severe patients were higher than slightly-moderately, light-medium（P〈0.05）. Conclusion The recurrent CAT carotid vulnerable plaques may have affected the occurrence of cerebrovascular events, which is worthy of more attention in clinic.