老年人颈动脉粥样硬化、超敏C-反应蛋白与脑梗死的关系

目的研究60岁以上老年人不同程度颈动脉粥样硬化、超敏C-反应蛋白（hs-CRP）水平与缺血性脑梗死的关系.方法对200例老年患者行颈动脉彩色超声检查,并检测hs-CRP以及进行头颅CT或MRI扫描.观察不同年龄段患者颈动脉粥样硬化的发生率,分析脑梗死与不同级别颈动脉斑块及hs-CRP水平的关系.结果随年龄增加,患者的颈动脉斑块检出率及2级以上斑块的检出率显著增高（P〈0.01）,有斑块组患者脑梗死发生率显著高于无斑块组（P〈0.01）,斑块级别2级以上的患者其hs-CRP水平显著增高（P〈0.01）,脑梗死组较非脑梗死组患者的hs-CRP水平明显增高（P〈0.01）.结论高龄是动脉粥样硬化加重的重要危险因素.颈动脉粥样硬化与脑梗死密切相关,斑块级别越高,脑梗死发生率越高.颈动脉超声检查有助与判断缺血发生机制和评价危险因素.hs-CRP水平能够提示斑块不稳定性,它与脑梗死的发生、发展密切相关,有望成为脑梗死早期检测和预后判断的生物学指标.

Relationship among Carotid Artery Atherosclerosis, the Level of High Sensitivity C-reactive Protein and Ischemic Cerebral Infarction in the Elderly

Objective To study the relationship among varying degrees of carotid artery atherosclerosis, the level of high sensitivity C-reactive protein and ischemic cerebral infarction in the elderly over 60. Methods Carotid artery color Doppler ultrasonography was performed in 200 old patients, their levels of high sensitivity C-reactive protein were measured, and their cranial CT or MRI was performed. The incidence of ,carotid atherosclerosis was observed in different ages. The relationship among cerebral infarction, carotid atherosclerosis plaques with different grades and the level of high sensitivity C-reactive protein were analyzed. Results The detection rates of carotid plaques and carotid plaque grade 2 or more in patients of advanced age were significantly increased （P 〈 0.01 ）. The incidence of cerebral infarction in the plaque group was significantly higher than that in the non-plaque group （P 〈 0.01 ）. The level of hs-CRP was higher in carotid plaque grade 2 or more in patients （P 〈 0.01 ）. The group of cerebral infarction had higher level of hs-CRP than the group of non-cerebral infarction （P 〈 0.01 ）. Conclusions The advanced age is an important risk factor for aggravating degree of carotid artery atherosclerosis. Carotid atherosclerosis plaque is closely correlated with cerebral infarction. The higher of the plaque grade is, the higher of the incidence of cerebral infarction. So uhrasonography can be used to estimate the mechanism of ischemia and evaluate its risk factors. The level of hs-CRP is closely associated with the occurrence and development of cerebral infarction, it may become the biological markers in early detection and predicting the prognosis of cerebral infarction.