Apopotic gene Bax expression in carotid plaque

The expression of BAX in carotid atherosclerosis and its regulation is far from defined. Objectives To investigate BAX expression in stable/fibrous and instable/vulnerable carotid plaque and its clinical significance. Methods Twenty-five cases of carotid plaque specimens obtained from endarterectomy were divided into two groups, stable/fibrous 14 cases, vulnerable/instable 11 cases; aortic artery and its branches from hepatic transplantation donors 6 case as control. The expression of proapoptotic BAX was detected by immunohistochemistry (IHC), in situ hybridization(ISH) and in situ TdT dUTP nick end labeling (TUNEL). Results Five cases of BAX ( + ) were detected by ICH and ISH, 4 case of TUNEL ( + ) were detected by TUNEL in stable/fibrous carotid plaque , while 10 cases were BAX ( + )by IHC(P < 0.05) , 11 cases by ISH and 9 cases by TUNEL were detected in instable/vulnerable carotid plaque ( P < 0.01 ), respectively. The intensity of BAX ( + ) cells by IHC and ISH was (8.63 +/- 2.62) and (10.32 +/- 3.12) in fibrous plaques, whereas (122 +/- 21.64) and (152 +/- 23.35) in vulnerable plaques, respectively. No expression of BAX was found in controlled group. Conclusion The higher expression of Bax in vulnerable carotid plaque may be one mechanism in molecular pathogenesis of carotid atherosclerosis which affect plaque stability and be the cause of higher incidence of stroke than fibrous carotid plaques, the regulation of BAX expression in different stage of atherosclerosis may provide targets in gene therapy for carotid atherosclerosis.     

MMP-8在颈动脉粥样斑块中的表达

目的 研究基质金属蛋白酶 8(MMP 8)在颈动脉不同类型粥样斑块中的表达与斑块破裂的关系。 方法30例人体成熟型颈动脉粥样斑块来源于颈动脉内膜剥脱术取材 ,由组织病理学分为稳定型 (16例 )和不稳定型(14例 )两组 ,6例来源于肝移植供者正常腹主动脉和分支为对照组。用免疫组化的方法测定MMP 8在粥样斑块不同细胞成分中的表达。结果 在稳定型斑块中 ,MMP 8表达 9例 ,不稳定型斑块中MMP 8表达 13例 ,对照组无表达 (P <0 .0 5 ) ,且在不稳定型斑块中MMP 8表达量明显上调 ,每个高倍视野阳性细胞计数不稳定型斑块为79 .5 7± 6 .74 ,稳定型斑块为 34.4 4± 7.2 5 (P =0 .0 0 0 1)。MMP 8表达不仅存在于单核—巨噬细胞 ,而且也存在于平滑肌细胞和泡沫细胞。结论 MMP 8在颈动脉不稳定型斑块中的表达明显高于稳定型斑块 ,可能是决定斑块不稳定性的重要相关因子之一。数据有可能为筛选抑制剂和基因治疗颈动脉狭窄提供参考。     

氟伐他汀对老年患者颈动脉粥样硬化斑块的影响及其机制

目的探讨氟伐他汀对老年患者颈动脉粥样硬化斑块(CAAP)的影响及其可能机制。方法经彩色多普勒超声仪证实存在CAAP的患者92例,经8周氟伐他汀40mg/d洗脱期后,随机分为A组(48例,氟伐他汀40mg/d)及B组(44例,氟伐他汀80mg/d),并给予相应的治疗40周;观察治疗前后CAAP面积、总胆固醇(TC)、低密度脂蛋白(LDL)及高敏C-反应蛋白(hs-CRP)水平的变化。结果A组及B组各40例患者完成48周的氟伐他汀治疗。治疗后,A组及B组斑块面积由治疗前(0.20±0.18)cm2及(0.20±0.19)cm2明显缩小为(0.12±0.15)cm2及(0.11±0.12)cm2(均P<0.05),但两组间差异无统计学意义。治疗后A组血清TC[(3.82±0.89)mmol/L]、LDL[(2.27±0.66)mmol/L]及hs-CRP[(3.73±3.67)mmol/L]水平较治疗前[(4.25±1.03)mmol/L、(2.68±0.71)mmol/L、(3.93±3.71)mmol/L]显著下降(均P<0.05);B组治疗后血清TC[(2.57±0.89)mmol/L]、LDL[(1.28±...     

脑梗死患者颈动脉粥样硬化斑块形成的研究

目的 探讨脑梗死(CI)患者颈动脉粥样硬化斑块形成的状况.方法 对138例CI患者行颈动脉彩色多普勒超声检查,观察其颈动脉斑块形成、性质及部位,并与正常对照组比较.结果 CI组138例中120例(87.7%)检出颈动脉粥样硬化斑块175块,正常对照组140人检出斑块为36人(25.7%)(P＜0.01).CI组中不稳定性斑块比率(80.8%)显著高于稳定性斑块(19.2%)(P＜0.01);斑块位于颈总动脉(CCA)(81.1%)显著高于颈内动脉(ICA)(18.9%)(P＜0.01);位于CCA分叉处(66.3%)又显著高于主干(14.9%)(P＜0.05).结论 CI患者颈动脉粥样硬化斑块的发生率高,多位于CCA分叉处,且大多为不稳定性斑块.提示CI与颈动脉粥样硬化有密切关系.     

Preoperative B-mode ultrasound plaque appearance compared with carotid endarterectomy specimen histology

In carotid artery stenosis both the degree of the lesion and its plaque morphology are thought to be associated with the carrier's thromboembolic risk. In this study we evaluated the diagnostic preciseness of non-invasively B-mode ultrasound in predicting the histopathological plaque structure. We examined 44 patients with > 50% ICA stenosis by B-mode within 6 weeks prior to carotid endarterectomy. At the affected bifurcations, up to 10 different regions of interest (ROI) per artery were investigated. Plaque appearance was classified according to 6 subtypes considering different ultrasonic plaque features. Postoperatively, plaque specimens were examined histopathologically for their relative content of calcification, fibrous tissue and different soft tissue. B-mode ultrasound was compared with histopathological features in ROI. A total of 265 regions of interest were evaluated. In mainly echolucent types of plaques, atheromatous debris was most frequently seen, whereas fibrosis was rare. Homogeneous echolucent plaques showed a high proportion of cholesterol and/or recent haemorrhage. Thrombosis at the plaque surface was often seen in "completely echolucent" plaque type (each P<0.001). Carotid B-mode ultrasonography is able to predict the histopathological components and the texture of carotid plaques.     

颅外段颈动脉硬化病变对老年缺血性脑卒中作用的研究

目的　探讨不同亚型的缺血性脑卒中人群的颅外段颈动脉硬化病变的发生状况及病变程度是否存在差异 ,为缺血性脑卒中的防治、预测提供依据。方法　收集神经内科住院的老年急性缺血性脑卒中病例 ,对其进行卒中病灶影像学检查 ,依据病灶部位将卒中分为皮质型 (CI)、皮质下型 (SCI)和基底动脉型 (VBCI)三个亚型 ;同时采用B超对颅外段颈动脉病变进行量化评估 ,分析各型之间颅外段颈动脉病变的发生状况及病变程度的差异 ,并进行统计学分析。结果　 (1)颅外段颈动脉动脉硬化病变发生率高达 5 8 7% (12 8/ 2 18) ,血管重度度狭窄 32例 (14 7% ) ,轻度狭窄 96例 (44 0 % ) ,无血管狭窄 90例 (41 3% )。 (2 )各型脑卒中中以CI组血管病变发生率最高、程度最重 ,而且重度血管狭窄发生率最高。结论　颅外段颈动脉硬化病变的发生状况及病变程度在缺血性脑卒中各亚型之间是存在差异 ,其中以CI的病变最明显。颅外段颈动脉硬化病变对CI的发生影响较SCI和VBCI明显。     

颈动脉粥样硬化患者血清基质金属蛋白酶-9水平、颈动脉斑块及其与人巨细胞病毒感染的关系

目的 探讨颈动脉粥样硬化(CAS)患者基质金属蛋白酶(MMP)-9水平、颈动脉斑块及其与人巨细胞病毒(HCMV)感染的相关性.方法 对90例CAS患者的HCMV-PP65抗原、血清MMP-9水平和颈动脉彩色多普勒超声检测结果进行分析和比较.结果 (1)HCMV阳性(A组)、HCMV阴性(B组)及正常对照者(C组)血清MMP-9含量分别为(260.25±89.03)pg/ml、(157.47±78.28)pg/ml、(138.65±80.73)pg/ml,A组显著高于B组与C组(均P＜0.01);B组及C组间差异无统计学意义.(2)A组颈动脉不稳定斑块检出率为81.25%(39/48),软斑积分为(2.905±0.768)分,显著高于B组[59.52%(25/42),(1.750±0.463)分](均P＜0.05);A组硬斑积分[(2.273±0.647)分]与B组[(2.364±0.658)分]比较差异无统计学意义.结论 CAS伴HCMV-PP65抗原阳性患者血清MMP-9水平明显增高,CAS斑块检出率高,且更具不稳定性.     

缺血性脑血管病患者颈动脉颅外段动脉粥样硬化的临床特征

目的 探讨缺血性脑血管病(ICVD)患者颈动脉颅外段动脉粥样硬化的临床特征.方法 对102例颈内动脉系统ICVD患者及31名性别、年龄相匹配的健康对照者进行颈动脉彩色超声检测.结果 102例ICVD患者颈动脉颅外段斑块发生率(71.6%)显著高于健康对照组(45.2%)(P＜0.01),颈动脉颅外段狭窄＞50%发生率(20.6%)显著高于健康对照组(3.2%)(P＜0.01);ICVD组患者颈动脉颅外段软斑数[(1.23±2.16)个]、颈总动脉内膜-中层厚度(IMT)[(2.02±0.77) mm]、斑块总积分[(0.52±0.64) cm]、软及混合斑积分比例[(0.69±0.12) %]以及数目构成比(155/228,68.0 %)与健康对照组[(0.10±0.54)、(1.65±0.49) mm、(0.10±0.16) cm、(0.27±0.04) %、(4/23,17.4%)]的差异有统计学意义(均P＜0.01);ICVD组颈动脉颅外段血栓形成(斑块破裂)13例(12.7%),而健康对照组无1例发生(P＜0.05);两组扁平斑数、硬斑数、混合斑数及斑块内出血数差异无统计学意义(均P＞0.05);ICVD组中的患、健侧动脉粥样硬化程度相关指标差异无统计学意义(均P＞0.05).结论 ICVD组患者颈动脉颅外段斑块发生率高,狭窄主要与软、混合斑有关;斑块破裂常常与卒中事件相关;一侧的颈动脉硬化相关指标的检测,可为对侧颈动脉粥样硬化程度提供重要参考依据;常规进行颈动脉颅外段彩色超声检测,对ICVD患者颈动脉颅外段动脉粥样硬化严重程度及病因评估有重要的参考价值.     

Correlating cognitive impairment with carotid atherosclerosis and carotid artery stenosis in patients with acute cerebral infarction

BACKGROUND:Studies have demonstrated that carotid atherosclerosis and carotid artery stenosis are closely associated with cognitive impairment in patients with and without clinically evident cerebrovascular disease. OBJECTIVE: To investigate the correlation between the degree of pathological changes in carotid atherosclerosis, carotid artery stenosis, and cognitive impairment in patients with acute cerebral infarction through the use of color Doppler imaging. DESIGN, TIME AND SETTING: The present concurrent...     

CEA治疗伴对侧颈内动脉闭塞的颈动脉重度狭窄的疗效

目的评价颈动脉内膜剥脱术治疗一侧颈内动脉重度狭窄伴对侧颈内动脉闭塞的疗效。方法回顾性分析11例患者的临床资料,包括围手术期并发症及近远期疗效;并比较术前及术后3个月颈部及大脑中动脉血管血流峰值。结果即刻成功率为100%,术后患者脑缺血症状均得到改善,围手术期无病例死亡或缺血性脑卒中等严重并发症发生,仅有1例出现皮下血肿、1例出现短暂声音嘶哑,经积极治疗后均好转。随访率100%,随访时间6~61(32.5±17.2)个月。患者均无术侧颈动脉再狭窄,其中1例再发对侧缺血性脑卒中。术后患者颈动脉血流峰值及大脑中动脉收缩期血流峰值与术前比较差异有统计学意义(均P0.05)。结论对于一侧颈内动脉重度狭窄伴对侧颈动脉闭塞的高危患者,颈动脉内膜剥脱术具有满意的围手术期结果和较好的远期脑卒中预防疗效。     

辛伐他汀及阿司匹林干预对颈动脉粥样硬化的影响

目的观察辛伐他汀及阿司匹林干预对颈动脉粥样硬化的影响。方法120例合并颈动脉粥样硬化及血脂异常的缺血性脑血管病患者随机分为辛伐他汀组、阿司匹林组及辛伐他汀+阿司匹林组,分别给予相应的药物治疗6个月;比较3组治疗前后血清C-反应蛋白(CRP)、血脂水平及颈动脉内-中膜厚度(IMT)、颈动脉斑块面积的变化及脑血管事件复发率。结果3组治疗后血清CRP水平均较治疗前显著降低(均P<0.05);辛伐他汀组和辛伐他汀+阿司匹林组治疗后颈动脉IMT、斑块面积及血脂水平显著降低(均P<0.05);阿司匹林组治疗前后颈动脉IMT、斑块面积及血脂水平差异无统计学意义;辛伐他汀+阿司匹林组治疗后各项指标较另外两组改善更明显(均P<0.05);3组患者脑血管病复发率差异无统计学意义。结论辛伐他汀和阿司匹林联合干预对降低CRP水平,延缓和逆转颈动脉粥样硬化优于单一使用辛伐他汀或阿司匹林,并可预防脑血管病复发。     

Correlating cognitive impairment with carotid atherosclerosis and carotid artery stenosis in patients with acute cerebral infarction*★

BACKGROUND：Studies have demonstrated that carotid atherosclerosis and carotid artery stenosis are closely associated with cognitive impairment in patients with and without clinically evident cerebrovascular disease. OBJECTIVE： To investigate the correlation between the degree of pathological changes in carotid atherosclerosis, carotid artery stenosis, and cognitive impairment in patients with acute cerebral infarction through the use of color Doppler imaging. DESIGN, TIME AND SETTING： The present concurrent, non-randomized, controlled experiment was performed at the Departments of Neurology and Ultrasound, Affiliated Hospital of North Sichuan Medical College between November 2006 and August 2007. PARTICIPANTS： Fifty-five patients with cerebral infarction, consisting of 35 males and 20 females, aged 50–82 years, were admitted to the hospital between November 2006 and August 2007 and recruited for this study. An additional 30 subjects consisting of 18 males and 12 females, aged 47–78 years, that concurrently received a health examination at the same hospital, were also included as normal controls. METHODS： Intima-media thickness （IMT）, plaque shape, size, and echo intensity of all subjects were detected by color Doppler flow imaging. Assessment criteria： IMT 〉 1.0 mm was considered to be intimal thickening, and IMT 〉 1.2 mm was determined to be formed atherosclerotic plaques. In the position of the largest plaque, the degree of carotid artery stenosis was determined by the following formula： （1-cross-sectional area of residual vascular luminal area/vascular cross-sectional area） × 100%. Less than 30% exhibited mild stenosis, 30%-40% moderate stenosis, and 〉 50% severe stenosis. MAIN OUTCOME MEASURES： IMT and the degree of carotid artery stenosis were evaluated by color Doppler flow imaging. The Mini-Mental State Examination （MMSE）, as well as the clinical memory scale, was compared between patients with cerebral infarction and normal controls. RESULTS： In the cerebral infarc     

Tissue inhibitor of the metalloproteinases-3 gene polymorphisms and carotid plaque susceptibility in the Han Chinese population

Tissue inhibitor of metalloproteinases (TIMPs) are endogenous inhibitors of matrix metalloproteinases that are involved in normal cellular processes and in the development and progression of atherosclerosis. Our purpose was to evaluate the polymorphisms of the TIMP-3 genes for their associations with carotid plaques or with serum protein levels in the Han Chinese population. Two promoter variants, ?915A/G (rs2234921) and ?1296T/C (rs9619311), were genotyped in 548 subjects with no plaques, 462 subjects with echogenic plaques, and 427 subjects with mixture plaques. The serum TIMP-3 levels were measured using an enzyme-linked immunosorbent assay (ELISA). There was a strong linkage disequilibrium between ?1296T/C and ?915A/G (D′ = 1.0, r² = 0.991). The individuals with the genotype (TC+CC) were 1.8 times more likely to have mixture plaques than the individuals with the TT genotype (P = 0.001, OR: 1.836, 95%CI: 1.269–2.665). The frequency of the C allele in the mixture plaque group was significantly higher than in the no plaque group (P = 0.009, CI: 1.119–2.187). We observed a significant elevation of the TIMP-3 levels in the serum of patients affected with mixture plaques compared to those with no plaques (P = 0.013). The current data suggest that genetic variation in the TIMP-3 genes may contribute to individual differences in mixture plaque susceptibility in the Han Chinese population.     

血脂康对短暂性脑缺血发作患者颈动脉粥样硬化斑块和血脂的影响

目的探讨血脂康对短暂性脑缺血发作(TIA)患者颈动脉粥样硬化斑块和血脂水平的影响。方法65例有颈动脉粥样硬化斑块的TIA患者随机分为血脂康组和对照组;血脂康组口服血脂康及阿司匹林6个月,对照组仅口服阿司匹林。治疗前后进行颈动脉超声检查,观察颈动脉内中膜厚度(IMT)、粥样硬化斑块面积;检测血脂、血清一氧化氮(NO)及氧化低密度脂蛋白(oxLDL)浓度,比较治疗6个月内两组患者脑血管事件的发生率。结果治疗后,血脂康组血胆固醇、低密度脂蛋白、三酰甘油和oxLDL水平比治疗前明显下降,NO和高密度脂蛋白水平明显升高(均P<0.01);颈动脉IMT变薄及斑块面积减少,与对照组比较差异均有显著性(P<0.05～0.01)。血脂康组脑血管事件的发生率为9.7%,对照组为20.6%,两组间差异无显著性(P>0.05)。结论血脂康不仅有调整血脂的作用,还具有抗脂质氧化、保护血管内皮等多种作用,并能消除或稳定TIA患者的颈动脉粥样硬化斑块。     

超敏C反应蛋白与颈动脉粥样硬化斑块稳定性关系研究

目的 探讨血清超敏C反应蛋白(hs-CRP)水平与颈动脉粥样硬化斑块稳定性之间的关系.方法 86例颈动脉粥样硬化患者根据颈动脉超声多普勒检测斑块回声特征分为不稳定性斑块 (易损斑块组)38例和稳定性斑块(非易损斑块组)48例.另选40例无颈动脉粥样硬化斑块者作为正常对照组.采用ELISA法检测血清hs-CRP水平.结果 颈动脉粥样硬化患者血清hs-CRP水平明显高于正常对照组,差异有显著统计学意义 (P<0.05).颈动脉易损斑块组血清hs-CRP水平高于非易损斑块组,两组比较差异亦有显著统计学意义 (P<0.05).结论 血清hs-CRP水平与颈动脉粥样硬化斑块稳定性相关,提示血hs-CRP水平可作为动脉粥样硬化程度及斑块稳定性的指标之一.     

Interrater reliability of plaque morphology classification in patients with severe carotid artery stenosis

Objective - Ultrasonographic assessment of carotid artery plaque morphology is widely used to identify patients at high risk for stroke. However, the reliability of plaque analysis in high-grade stenosis is uncertain. We determined the interrater reliability of sonographic plaque morphology analysis in patients with severe carotid artery stenosis. Material and methods - Duplex Doppler was performed on 114 patients with 80–99% stenosis of the internal carotid artery using a Siemens Quantum 2000 D with a handheld 7.5 MHz transducer. B-mode pictures with and without color coding were printed on a Sony color video printer UP-5000 W. Three raters independently evaluated plaque echolucency, heterogeneity, calcification, and surface structure. Interrater agreement was calculated by a jackknife procedure generating kappa values and two-sided 95% confidence intervals. Results - Kappa values and 95% confidence intervals were 0.05 (-0.07 to 0.16) for plaque surface structure, 0.15 (0.02 to 0.28) for plaque heterogeneity, 0.18 (0.09 to 0.29) for plaque echogenicity, and 0.29 (0.19 to 0.39) for plaque calcification. The upper bounds of all of the confidence intervals were below the 0.40 level suggested for minimal reliability. Conclusion - The low interrater agreement indicated that unaided visual assessment of static B-mode pictures to assess plaque morphology in patients with severe carotid artery stenosis is not reliable. Other evaluation procedures and standardized criteria, as yet undeveloped, are needed to improve reliability.     

急性脑梗死患者血清内脂素水平的改变及其与颈动脉粥样硬化斑块形成和稳定性的关系

目的探讨急性脑梗死(ACI)患者血清内脂素水平的改变及其与颈动脉粥样硬化斑块形成和稳定性的关系。方法对89例ACI患者进行颈动脉彩色多普勒超声检查,并用ELISA法检测其和85例无脑梗死其他疾病患者(对照组)的血清内脂素水平。结果 ACI组患者颈动脉彩色多普勒超声检查发现,有颈动脉斑块61例,其中不稳定斑块41例(不稳定斑块亚组)、稳定性斑块20例(稳定斑块亚组),无斑块28例(无斑块亚组)。与对照组血清内脂素水平[(13.55±4.31)μg/L]比较,ACI组及不稳定斑块亚组、稳定斑块亚组[(19.38±5.53)μg/L、(22.26±5.83)μg/L、(18.72±4.42)μg/L]明显升高(均P0.05),而无斑块亚组[(15.49±4.47)μg/L]的差异无统计学意义。不稳定斑块亚组和稳定斑块亚组的血清内脂素水平明显高于无斑块亚组,而不稳定斑块亚组的血清内脂素水平又明显高于稳定斑块亚组(均P0.05)。结论 ACI患者的血清内脂素水平明显升高;并且血清内脂素与颈动脉粥样硬化斑块形成及其稳定性有密切的关系。     

Ultrasonographic markers of vascular risk in patients with asymptomatic carotid stenosis

Six-hundred twenty-one subjects with unilateral asymptomatic severe internal carotid artery (ICA) stenosis were prospectively evaluated with a median follow-up of 27 months (min=6, max=68). Vascular risk profile, plaque characteristic, stenosis progression, and common carotid artery intima-media thickness (IMT) were investigated in all patients. Outcome measures were occurrence of ischemic stroke ipsilateral to ICA stenosis and vascular death, while myocardial infarction, contralateral strokes, and transient ischemic attack were considered as competing events. A total of 99 subjects (15.9%) suffered from a vascular event. Among them, 39 were strokes ipsilateral to the stenosis (6.3%). Degree of stenosis, stenosis progression, and common carotid artery IMT resulted as independent predictive factors of ipsilateral stroke. Considering a stenosis of 60% to 70% as reference, a degree between 71% and 90% increased the risk by 2.45, while a degree between 91% and 99% increased the risk by 3.26. The progression of stenosis was a strong risk factor (hazard ratio=4.32). Finally, the role of carotid IMT was confirmed as crucial additional measure, with an increased risk by 25% for each 0.1 mm IMT increase. Our data suggest that IMT, stenosis progression and severity should be considered as risk factors for cerebrovascular events in asymptomatic subjects with severe ICA stenosis.     

颈动脉粥样硬化患者外周血内皮祖细胞部分生物学功能改变及其意义

目的:观察颈动脉粥样硬化患者外周血内皮祖细胞(endothelial progenitor cells,EPCs)生物学功能的改变,探讨EPCs在颈动脉粥样硬化发生发展中可能作用。方法:选择颈动脉粥样硬化患者和同年龄组正常人各20例,密度梯度离心法从外周血获取单个核细胞,接种在培养板内,培养7天后对贴壁细胞进行细胞化学分析和部分生物学功能测定。激光共聚焦显微镜鉴定FITC标记荆豆凝血素Ⅰ(FITC-UEA-I)和DiI标记的乙酰化低密度脂蛋白(DiI-acLDL)双染色阳性细胞为正在分化的EPCs。胰蛋白酶消化后计数贴壁细胞观察EPCs黏附能力;改良的Boyden小室观察EPCs的迁移能力;MTT法检测EPCs增殖能力;体外血管生成实验观察EPCs体外生成血管能力。结果:颈动脉粥样硬化患者外周血EPCs黏附细胞数(35.15±6.55)较正常对照组(45.25±7.04)显著减少(P<0.01);EPCs的增殖能力(0.649±0.033)较正常对照组(0.680±0.022)显著降低(P<0.05);颈动脉粥样硬化患者外周血EPCs体外血管生成能力较正常对照组显著减弱,并且小管的复杂程度也较对照组降低。结论:颈动脉粥样硬化患者外周血EPCs的黏附、迁移、增殖和成血管能力明显受损。EPCs的生物学功能或许可作为颈动脉粥样硬化患者血管病变发生发展的一个生物学标志。     

常德市汉族居民颈动脉粥样硬化斑块稳定性的相关因素分析

目的探讨影响常德市汉族居民颈动脉粥样硬化(CAS)斑块稳定性的相关因素。方法回顾性分析2014年1月至2014年12月期间在常德市第一人民医院门诊部就诊和体检中心进行体检的符合入组标准的对象794例,将入组对象分为稳定斑块组(353例)和不稳定斑块组(441例)。收集一般资料及生化检测结果。根据颈部血管彩色多普勒检查结果,对两组资料进行比较分析。结果单因素分析显示,两组在高血压、糖尿病、吸烟、年龄、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、纤维蛋白原(FIB)、C-反应蛋白(CRP)和同型半胱氨酸(Hcy)指标上差异有统计学意义(P0.05)。多因素Logistic回归分析显示,糖尿病(OR=3.115,95%CI:2.163~4.487,P=0.000)、高血压(OR=1.991,95%CI:1.429~2.772,P=0.000)、吸烟(OR=1.372,95%CI:1.001~1.879,P=0.049)、LDL-C(OR=1.308,95%CI:1.084~1.578,P=0.005)、FIB(OR=1.291,95%CI:1.055~1.580,P=0.013)、TC(OR=1.216,95%CI:1.001~1.477,P=0.049)、年龄(OR=1.033,95%CI:1.017~1.048,P=0.000)和Hcy(OR=1.031,95%CI:1.009~1.053,P=0.006)是CAS不稳定斑块形成的危险因素,差异具有统计学意义(P0.05)。HDL-C(OR=0.447,95%CI:0.270~0.740,P=0.002)是CAS不稳定斑块形成的保护因素,差异具有统计学意义(P0.05)。结论糖尿病、高血压、吸烟、LDL-C、FIB、TC、Hcy和年龄是常德市汉族居民CAS不稳定斑块的危险因素,HDL-C是常德市汉族居民CAS斑块稳定性的保护因素。