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老年急性缺血性脑卒中患者疾病分型和严重程度与颈动脉斑块性质和血液流变学的关系 被引量:23

Relationshop between carotid plaque nature, hemorheology and classification, severity of disease in elderly people with acute ischemic stroke
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摘要 目的探讨>65岁急性缺血性脑卒中患者颈动脉斑块性质,以及外周血液流变学指标与卒中病情严重程度的关系,为临床早期判断病情和预测疾病转归提供参考。方法选取2016年10月—2018年10月永康市第一人民医院首次诊断急性缺血性脑卒中患者300例。根据牛津郡社区卒中计划将患者分为完全前循环型组、部分前循环型组、后循环型组和腔隙型组。另选择>65岁无脑卒中健康志愿者50例作为对照组。采用多普勒超声检测颈动脉内中膜厚度(IMT)、斑块数量、最大长径和性质,全自动生化分析仪检测全血黏度、血浆黏度、红细胞压积(HCT)、血沉(ESR)、血浆纤维蛋白原(Fib)、胆固醇、甘油三酯和血糖水平。结果完全前循环型组、部分前循环型组、后循环型组和腔隙型组IMT较对照组增厚、斑块数量较对照组增多、最大长径较对照组变大、全血黏度、血浆黏度、HCT、ESR及Fib水平均较对照组升高(P<0.05),完全前循环型组、部分前循环型组和后循环型组各指标数值均较腔隙型组升高(P<0.05)。中、重度组IMT、斑块数量、最大长径、全血黏度、血浆黏度、HCT、ESR及Fib数值较轻度组升高(P<0.05),重度组各指标数值较中度组升高(P<0.05)。结论>65岁老年人急性缺血性脑卒中严重程度往往与颈动脉斑块形成和血液流变学异常有关。 Objective To analyze carotid plaque nature by color doppler ultrasound and peripheral hemorheological parameters by blood biochemistry in people more than 65 years with acute ischemic stroke(AIS)for assessing severity of stroke.Method A total of 300 AIS patients for first diagnosis from October 2016 to October 2018 were enrolled,including total anterior circulation group(TACI),partial anterior circulation group(PACI),posterior circulation group(POCI)and cavity type group(CA)according to oxfordshire community stroke project(OCSP),and other 50 healthy persons more than 65 years as control group.Then we used doppler ultrasound to detect carotid intima-media thickness(IMT),plaque number,maximum length and nature,whole blood viscosity,plasma viscosity,hematocrit(HCT),erythrocyte sedimentation rate(ESR),plasma fibrinogen(Fib),cholesterol(TC),triglyceride(TG)and blood sugar with automatic biochemical analyzer.Results IMT,number of plaques,maximum length diameter,whole blood viscosity,plasma viscosity,HCT,ESR and Fib in TACI,PACI,POCI and CA groups were all significantly increased compared with control group(P<0.05).Moderate and severe group were higher than mild group(P<0.05),and the severe group was higher than the moderate group(P<0.05).Conclusions The severity of acute ischemic stroke in patients over 65 year old is often related to the formation of carotid plaque and hemorheology.
作者 徐军鹏 胡国豪 黄方剑 Jun-peng Xu;Guo-hao Hu;Fang-jian Huang(Department of Emergency,The First People’s Hospital of Yongkang,Yongkang,Zhejiang 321300,China)
出处 《中国现代医学杂志》 CAS 2019年第22期108-112,共5页 China Journal of Modern Medicine
关键词 卒中 脑缺血 急性病 诊断试验 常规 stroke brain ischemia acute disease diagnostic tests,routine
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