无症状脑梗死患者炎症因子与颈动脉粥样硬化的关系

The relationship between inflammatory factors and carotid atherosclerosis in patients with asymptomatic cerebral infarction

目的研究无症状脑梗死患者白细胞、中性粒细胞、淋巴细胞、中性粒细胞/淋巴细胞比值(NLR)、单核细胞、单核细胞/高密度脂蛋白胆固醇比值(MHR)与颈动脉粥样硬化的关系。方法收集2019年1月-2019年6月在徐州医科大学附属医院住院治疗的无症状脑梗死患者为ACI(asymptomatic cerebral infarction)组;选取同期我院体检中心健康体检者作为对照组。收集多普勒超声检测的颈动脉内膜中层厚度(CIMT)结果,继而把ACI组分为CIMT正常组和CIMT增厚组,依据颈动脉内斑块回声性质分为无斑块组、稳定斑块组和不稳定斑块组;同时收集各组白细胞计数(WBC)、中性粒细胞计数(NEUT)、淋巴细胞计数(LY)、单核细胞计数(MONO)的化验结果,计算单核细胞与高密度脂蛋白胆固醇比值(MHR)及中性粒细胞与淋巴细胞比值(NLR),探讨无症状脑梗死各项炎症因子与颈动脉增厚的关系。结果①ACI组和对照组患者在血浆WBC、NEUT、LY、NLR、单核细胞及MHR方面有显著性差异(P<0.05)。②ACI组中的CIMT增厚率(31.9%)明显高于对照组(P<0.05)。③ACI组内CIMT增厚组和CIMT正常组两个亚组间在WBC、NEUT、NLR、单核细胞、MHR方面有显著性差异(P<0.05)。④ACI患者中稳定斑块和不稳定斑块患者WBC、单核细胞、MHR值均明显高于无斑块患者,不稳定斑块患者MHR(39.97±21.32)均明显高于稳定斑块和无斑块患者(P<0.05)。结论颈动脉粥样硬化的程度、硬化斑块的性质及炎症因子与无症状脑梗死紧密关联;MHR能较准确地反映颈动脉斑块的稳定性。

Objective In order to investigate the relationship between white blood cells,neutrophils,lymphocytes,neu-trophil/lymphocytes ratio(NLR),monocytes,monocyte/HDL-C ratio(MHR)and carotid atherosclerosis in patients with asymptomatic cerebral infarction(ACI).Methods ACI patients hospitalized in the Department of the Affiliated Hospital of Xuzhou Medical University from January 2019 to June 2019 were collected as the ACI group.Healthy subjects in the physical examination center of our hospital during the same period were selected as the control group.Data of carotid artery intima-media thickness(CIMT)determined by Doppler ultrasound were collected.According to the results,ACI group was further divided into CIMT normal group and CIMT thickening group.Based on the echo nature of carotid plaque,the plaques were divided into three groups:non-plaque group,stable plaque group and unstable plaque group.At the same time,the test results of white blood cell count(WBC),neutrophil count(NEUT),Lymphocyte count(LY),and monocyte count(MONO)of each group were collected.MHR and NLR results were calculated for statistical processing.The association between inflammatory factors and carotid artery thickening was explored in patients with as-ymptomatic cerebral infarction.Results①There were significant differences in WBC,NEUT,LY,NLR,MONO and MHR between the ACI group and the control group(P<O.05).②CIMT thickening rate in the ACI group(31.9%)was significantly higher than thal in the control group(P<0.05).③There were significant differences in WBC,NEUT,LY,NLR,MONO and MHR between the CIMT thickening group and CIMT normal group in the ACI group(P<0.05).④In the ACI group,the levels of WBC,monocyte,and MHR in patients with stable and unstable plaques were significantly higher than those in patients without plaque,and MHR(39.97±21.32)in patients with unstable plaque was significantly higher than that in patients with stable plaque and without plaque(P<0.05).Conclusion The degree of the carotid atherosclerosis,nature of plaque and inflammatory factors are closely associated with asymptomatic cerebral infarction;the MHR level can accurately reflect the stability of carotid plaque.