前循环梗死/短暂性脑缺血发作患者血纤维蛋白原水平与颈动脉粥样硬化的相关性研究

摘要】 目的 分析前循环梗死/短暂性脑缺血发作（transient ischemic attack，TIA）患者颈动脉粥样硬化情况，明确血纤维蛋白原水平对颈动脉粥样硬化的影响。 方法 对69例前循环梗死/短暂性脑缺血发作患者进行颈动脉彩色多普勒超声检查，记录颈动脉粥样硬化斑块的部位、大小、数目、回声、颈总动脉分叉处内膜中层厚度（intima-media thickness，IMT）及血管内径，并测量首次血压、美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）、纤维蛋白原测定及D-二聚体。 结果 颈动脉粥样硬化斑块位于颈总动脉分叉处最多（占52.29%）。IMT≥0.9&#8197;mm组血纤维蛋白原水平显著高于IMT<0.9&#8197;mm组（P<0.05）。中、高浓度纤维蛋白原组（≥3.0&#8197;g/L）易损斑块数量明显增多，且较低浓度组IMT明显增厚（P<0.01），两组D-二聚体比较有统计学意义（P<0.05）。颈动脉平均IMT与患者收缩压、舒张压以及纤维蛋白原水平密切相关（r=4.92、5.26、6.68，P均<0.05） 结论 作为卒中患者的重要危险因素之一，血纤维蛋白原水平与前循环梗死/短暂性脑缺血发作患者颈动脉粥样硬化程度密切相关。

Relationship between the Level of Plasma Fibrinogen and Carotid Atherosclerosis in Patients with Anterior Circulation infarction/Transient Ischemic Attack

【Abstract】 Objective To analyze carotid atheromatous plaque in patients with anterior circulation infarction/transient ischemic attack (TIA) and explore the relationship between carotid atherosclerosis and the levels of plasma fibrinogen.Methods In sixty-nine cases with anterior circulation infarction/TIA, the location, number, characteristic of carotid atheromatous plaque and diameter of carotid artery and Intima-media thickness (IMT) of bifurcation of common carotid artery were assessed by Doppler ultrasonography, and other related indexes, such as blood pressure, NIHSS, the level of plasma fibrinogen and D-Dimer were evaluated.Results The atheromatous plaques were most in bifurcation of common carotid artery (52.29%).The level of plasma fibrinogen in the group of IMT≥0.9&#8197;mm was obviously higher than that in the group of IMT<0.9&#8197;mm (P<0.05). The numbers of carotid atheromatous plaque and IMT in the group of high level fibrinogen (≥3.0&#8197;g/L) were obviously higher than that in the group of low level fibrinogen (P<0.01), and the level of plasma D-Dimer between the both groups also has significant difference (P<0.01). The IMT of bifurcation of common carotid artery was directly associated with the systolic pressure, diastolic pressure and level of plasma fibrinogen(r=4.92, 5.26, 6.68, all P<0.05).Conclusion As one of the most important risk factors of ischemic stroke, the level of plasma fibrinogen was directly associated with carotid atherosclerosis in patients with anterior circulation infarction/TIA.