短暂性脑缺血发作、单/多发腔隙性脑梗死患者血纤维蛋白原水平与颈动脉及下肢动脉粥样硬化的相关性研究

目的探讨短暂性脑缺血发作（transient ischemic attack,TIA）、单/多发腔隙性脑梗死患者颈动脉及下肢动脉粥样硬化情况,明确血纤维蛋白原水平对颈动脉及下肢动脉粥样硬化的影响。方法对178例短暂性脑缺血发作、单/多发腔隙性脑梗死患者进行颈动脉及下肢动脉彩色多普勒超声检查,记录颈动脉及下肢动脉粥样硬化斑块的部位、大小、数目、回声、动脉分叉处内膜中层厚度（inti ma-media thickness,I MT）及血管内径,并测量血压及纤维蛋白原测定。结果颈动脉粥样硬化斑块位于颈总动脉分叉处最多（占58.3%）。I MT≥1.2mm组血纤维蛋白原水平显著高于I MT〈1.2mm组（P〈0.05）。下肢动脉粥样硬化位于股动脉最多（占49.6%）,I MT≥1.2mm组血纤维蛋白原水平显著高于I MT〈1.2mm组（P〈0.05）。高水平纤维蛋白原组（≥3.0g/L）易损斑块数量明显增多（P≤0.05）。颈动脉I MT与患者收缩压、舒张压以及纤维蛋白原水平呈正相关（r=4.89、5.37、6.47,P均〈0.05）,下肢动脉I MT与血糖及纤维蛋白原水平呈正相关（r=4.83、5.38、6.68,P均〈0.05）。结论血纤维蛋白原水平与短暂性脑缺血发作、单/多发腔隙性脑梗死患者颈动脉及下肢动脉粥样硬化程度呈正相关。

The relationship between the level of plasma fibrinogen and carotid/lower limb atherosclerosis in patients with transient ischemic attack and single/multiple lacunar cerebral infarction

Objective To analyzes carotid/lower limb atheromatous plaque in patients with transient ischemic attack（TIA）.single/multiple lacunar cerebral infarction and explore the relationship between carotid/ lower limb atherosclerosis and the levels of plasma fibrinogen. Methods In one hundred and seventy-eight cases of TIA or single/multiple lacunar cerebral infarction, the location, size, number, nature of carotid/lower limb atheromatous plaque, diameter of artety and intima-media thickness （IMT）of bifurcation of common carotid artery were assessed by Doppler ultrasonography, and other related indexes, such as blood pressure and the level of plasma fibirinogen were also evaluated. Results The carotid atheromatous plaques were the most at the bifurcations of common carotid artery（58. 3%）. The level of plasma fibrinogen in the group of IMT≥1. 2 mm was higher than that in the group of IMT〈1. 2 mm（P〈0. 05）. The lower limb atheromatous plaques were the most in femoral artery （49. 60%）. The level of plasma fibrinogen in the group of IMT≥1. 2 mm was higher than that in the group of IMT〈1. 2 mm（P〈0. 05）. The number of carotid/lower limb atheromatous plaque in the group of high level fibrinogen（≥3.0 g/L）was higher than that in the group of low level fibrinogen （P≤0. 05）. The IMT of bifurcation of common carotid artery was directly associated with the systolic pressure, diastolic pressure and level of plasma fibrinogen（r = 4. 89,5. 37,6. 47, all P〈O. 05）. The IMT of lower limb artery was directly associated with the glycemic level and level of plasma fibrinogen（r = 4. 83,5. 38,6. 68, all P〈 0. 05）. Conclusions As one of the most important risk factors of ischemic stroke, the level of plasma fibrinogenis directly associated with carotid/lower limb atherosclerosis in patients with TIA. single/multiple lacunar cere- bral infarction.