颈动脉粥样硬化斑块性质、血清hs-CRP水平在脑梗死发病预测及病情判定中的应用

目的观察脑梗死患者颈动脉粥样硬化斑块性质及血清超敏-C反应蛋白（hs-CRP）水平变化，并分析两指标在脑梗死发病预测及病情判定中的意义。方法研究对象为83例前循环脑梗死患者（梗死组）和50例健康体检者（对照组），分别采用颈动脉彩超检查颈动脉粥样硬化斑块及其性质、内一中膜厚度（IMT），采用免疫比浊法检测血清hs．CRP水平，分析血清hs-CRP水平与IMT及神经功能障碍程度的关系。结果梗死组斑块阳性率、IMT及血清hs-CRP水平均高于对照组，且不稳定斑块者血清hs-CRP、IMT及同侧脑梗死发生率均高于稳定斑块者，差异均有统计学意义（P均〈0．05）；血清hs—CRP水平与IMT及神经功能障碍程度均呈正相关，P均〈0．05（r值分别为0．67、0．58）。结论脑梗死患者颈动脉粥样硬化斑块阳性率及血清hs-CRP水平升高，且颈动脉粥样硬化斑块稳定性与脑梗死发生密切相关，血清hs-CRP水平与脑梗死患者颈动脉粥样硬化斑块稳定性及神经功能损害程度有关，两者联合检测有助于脑梗死发病的预测及病情判断。

Application of carotid atherosclerotic plaque and hs-CRP level in prediction and determination of cerebral infarction

Objective To observe the association of carotid atherosclerotic plaque and serum high-sensitivity C-reac tive protein （hs-CRP） level with cerebral infarction and to investigate the clinical application value that combined detec tions of carotid color uhrasonography and serum hs-CRP in patients with cerebral infarction. Methods Eighty-three cases of patients with anterior circulation infarct as the experiment group and 50 cases of healthy volunteers as the control group were selected. Carotid color ultrasonography was employed to detect the carotid plaque and intima-media thickness （IMT） , and immunotnrbidimetry was used to detect the levels of serum hs-CRP, and then the relationship between serum hs-CRP and IMT in different degrees of patients with cerebral infarction was analyzed. Results The positive incidence of carotid plaque, levels of IMT and serum hs-CRP in the experiment group were higher than those of the control group; the IMT and serum hs-CRP levels, incidence of cerebral infarction at the same side of infarction side in unstable plaque were higher than those in stable plaque ; significant difference was found （ all P 〈 0.05 ）. The serum hs-CRP was positively correlated with IMT, and there was positive correlation between serum hs-CRP and serious degree of cerebral infarction patients （ r = 0.67, r = 0.58 ; all P 〈 0.05 ）. Conclusions Carotid color uhrasonography displays that there is significant correlation between carotid atherosclerotic stable plaque and cerebral infarction. The level of serum hs-CRP not only assesses carotid unstable plaque, but also reflects serious degree of cerebral infarction. Combined detections of carotid color ultrasonography and ser um hs-CRP level can help the prediction and determination of cerebral infarction.