急性脑梗死患者同型半胱氨酸、超敏C反应蛋白和纤维蛋白原水平与颈动脉硬化的关系

Exploration of the Relationship between Homocysteine,High-sensitivity C-reactive Protein,Fibrinogen Levels and Carotid Atherosclerosis in Patients with Acute Cerebral Infarction

目的探讨急性脑梗死(ACI)患者血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)和血浆纤维蛋白原(Fib)水平与颈动脉粥样硬化及其严重程度的相关性。方法对112例急性脑梗死患者(ACI组)和63例健康体检者(对照组)行颈动脉彩色多普勒超声检查,并根据IMT值将患者分为3组:内膜正常组23例,内膜增厚组40例,斑块形成组49例。同时检测所有观察对象的血清Hcy、hs-CRP和血浆Fib水平,并分析ACI患者血清Hcy、hs-CRP和血浆Fib水平与颈动脉粥样硬化及其严重程度的相关性。结果 ACI患者血清Hcy、hs-CRP和血浆Fib水平及颈动脉IMT测量值均明显高于对照组(P <0. 001)。与内膜正常组比较,内膜增厚、斑块形成组ACI患者的血清Hcy、hs-CRP和血浆Fib水平均显著增高(P <0. 01);而斑块形成组ACI患者的血清Hcy、hs-CRP和血浆Fib水平又明显高于内膜增厚组(P <0. 01)。ACI患者颈动脉IMT测量值与血清Hcy、hs-CRP和血浆Fib水平均呈明显正相关(P <0. 001)。结论 ACI患者血清Hcy、hs-CRP和血浆Fib水平与颈动脉粥样硬化及其严重程度密切相关,提示Hcy、hs-CRP和Fib可能参与脑梗死发病机制。

Objective To investigate the correlation between homocysteine( Hcy),high-sensitivity C-reactive protein( hs-CRP),fibrinogen levels( Fib) and carotid atherosclerosis in patients with acute cerebral infarction. Methods Carotid color Doppler ultrasonography was performed in 112 patients with acute cerebral infarction( the acute cerebral infarction group) and 63 healthy subjects( the control group),and the patients were divided into 3 groups according to the IMT value: 23 cases of normal endometrium,40 cases of intimal thickening,49 cases of plaque formation. The levels of Hcy,hs-CRP and plasma Fib were tested,the correlation between levels of Hcy,hs-CRP,Fib in patients with acute cerebral infarction and carotid atherosclerosis were analyzed. Results The levels of Hcy,hs-CRP,Fib and carotid IMT were significantly higher in patients with acute cerebral infarction than in the control group( P < 0. 001). Compared with the normal endometrium group,levels of Hcy,hs-CRP,and Fib were significantly increased in patients with acute cerebral infarction in the intimal thickening and plaque formation groups( P < 0. 01). Levels of Hcy,hs-CRP and Fib in patients with acute cerebral infarction in the plaque formation group were significantly higher than those in the intima thickening group( P < 0. 01).Carotid IMT measurements in patients with acute cerebral infarction were positively correlated with levels of Hcy,hs-CRP and Fib( P < 0. 001). Conclusion Levels of Hcy,hs-CRP and Fib in patients with acute cerebral infarction are closely related to carotid atherosclerosis and its severity,which suggested that Hcy,hs-CRP and Fib may be involved in the pathogenesis of cerebral infarction.