血浆纤维蛋白原水平与脑大动脉狭窄的相关分析

目的探讨血浆纤维蛋白原(Fib)水平与脑大动脉狭窄程度的相关性。方法选择行全脑数字减影血管造影术(DSA)检查的急性缺血性脑卒中患者317例.根据DSA显示动脉狭窄是否≥50%为依据。分为两组:狭窄组(174例)患者颅内、外脑大动脉至少1支血管狭窄≥50%;对照组(143例)患者无狭窄或血管狭窄<50%。检测两组血浆Fjb及血脂水平等,按Fib值分4个水平(Fib<2.96 g/L,Fib 2.96～3.47 g/L,Fib 3.48～4.06 g/L,Fib>4.06 g/L)观察血管狭窄≥50%的发生率。进行多元逐步logistic回归分析。结果狭窄组血浆Fib水平和Fib水平异常患者的比例明显高于对照组(P<0.05)。随着Fib值的升高,血管狭窄≥50%患者的比例显著增加(χ~2=23.10.P=0.000),血浆Fib水平升高是脑大动脉粥样硬化狭窄独立的、且作用最强的危险因素(OR=1.558,95% CI:1.164～2.087.P=0.003)。结论 Fib升高与脑大动脉狭窄程度密切相关,其作用可能强于其他传统危险因素。

Association between plasma fibrinogen level and severity of cerebral large-artery stenosis

Objective To investigate the association between plasma fibrinogen(Fib) level and severity of cerebral large-artery atherosclerotic stenosis in patients with cerebral ischemic stroke. Methods 317 patients with ischemic stroke undergoing cerebral angiography(DSA) were studled. All patients were divided into two groups according to the findings of DSA. Stenosis group (n = 174) included patients with large-artery atherosclerotic stenosis(stenosis≥50% ,at least one of large arteries),and control group (n = 143) included patients without artery stenosis or mild stenosis(stenosis<50%). Results The Fib levels in large-artery atherosclerotie stenosis group were higher than those in control group. and rate of abnormal plasma Fib level(Fib>4.0 g/L) in large artery atherosclerotic stenosis group(36.78%) was also higher than that in control group (15.38%). The rate of large artery atherosclerotic stenosis(stenosis≥50%) increased gradually with tbe plasma level of the Fib (χ~2 = 23.10,P = 0.000). Multivariate stepwise logistic regression analysis showed tha plasma Fib level was an independent and strong risk factor for cerebral large artery atherosclerotic stenosis (OR = 1.558, 95% CI: 1.164-2.087, P = 0.003). Conclusions The elevated plasma Fib was significantly correlated with the severity of cerebral large-ar-tery atherosclerosis,and may play a more important role than other traditional risk factors.