颈动脉不稳定粥样斑块与进展性脑卒中的相关性研究

目的:观察颈动脉不稳定粥样斑块与进展性脑卒中的相关性,探讨进展性脑卒中的预测因素,更好的指导临床治疗。方法:选取2009年9月至2010年5月我院神经内科住院的发病24 h内急性脑梗塞患者97例,依据病情变化分为进展组和非进展组,并选取健康体检者20例作为对照组,比较3组不稳定颈动脉粥样斑块的特征。结果:进展组颈动脉斑块发生率(91.3%)远高于非进展组(60.8%),进展组以不稳定斑块为主(86.9%),发生率也远高于非进展组(23.5%);在进展组中,不稳定粥样斑块合并重度颈动脉狭窄者占16例(34.8%)远高于合并轻中度颈动脉狭窄者;进展组、非进展组与对照组血清超敏C反应蛋白分别为(15±9.53)mg/L、(2.8±6.9)mg/L、(1.34±1.02)mg/L,三组间差异有统计学意义(P<0.05)。结论:颈动脉粥样斑块不稳定性与进展性脑卒中的发生密切相关,而超敏C反应蛋白水平升高能预测脑卒中的发生发展。

The relationship between carotid artery instable plaque and progressive cerebral infarction

Objective: To observe the relation between carotid artery instable plaque and progressive cerebral infarction,then to investigate the ways of prediction and treatment.Methods: Ninety seven patients with stroke oneset less than 24 hours admitted to the department of neurology of our hospital from September 2009 to May 2010 were divided into progressing group and non-progressing group. The examiners without cerebrovascular and cardiovascular disease to be selected as control group in the same time.We compared the characteristics of carotid artery instable plaque of this three groups.Results: Instable plaque was the main type of plaque in the progressing group,and the incidence of it was higher in the progressing group than in the non-progressing group.In the progressing group,16(34.8%) patients of instable plaque combined with carotid high-grade stenosis were higher than low-grade stenosis.There were significant differences in the levels of hs-CRP among the progressing group[(15±9.53)mg/L]、the non-progressing group[(2.8±6.9)mg/L] and normal control group [(1.34±1.02)mg/L].Level of hs-CRP was significant different in instable plaque group(16.9±4.29)mg/L,stable plaque group(6.89±2.2)mg/L.Conclusion: Instable carotid plaque may be closed related to ischemic stroke in progressive,levels of hs-CRP was a predicting of progressive cerebral infarction.