急性脑梗死患者颈动脉斑块特征和C-反应蛋白水平及其关系

目的了解颈动脉粥样斑块稳定性及炎性反应与急性脑梗死之间的关系。方法对76例急性脑梗死患者(A组)、46例无症状颈动脉硬化患者(B组)和32例健康对照者(C组)进行研究,测定高敏C-反应蛋白(hs-CRP)水平,应用彩色多普勒超声仪观测颈动脉内膜-中层厚度(IMT)、斑块类型及形态。结果3组受试者hs-CRP水平间差异有统计学意义(P<0.01);A、B组颈动脉IMT较C组间差异有统计学意义(P<0.05);A组颈动脉斑块的发生率为78.9%(60/76),以不稳定斑块发生例数较多(52.6%),B组以稳定斑块发生例数较多(71.7%);A组斑块以不规则型为主(69.1%),B组斑块以规则型为主(52.8%)。结论颈动脉粥样斑块稳定性与急性脑梗死有关,颈动脉硬化与hs-CRP水平之间存在密切关系。

Study of Serum hs-CRP Level in Cerebral Infarction Patients with Different Characteristic Carotid Atherosclerotic Plaques

Objective To explore the role inflammation and plaque stability in the pathogenesis of acute cerebral infarction patients.Methods Seventy six patients with acute cerebral infarction located in arteriae carotis interna system(group A),46 patients with asyptomatic carotid atherosclerosis(group B),and 32 normal controls(group C)were investigated.The levels of high sensitive C-reactive protein(hs-CRP)were measured by ultra-sensitive immunoassay.The intima-media thickness(IMT),plaque echogenicity and morphology were evaluate bilatertally with a 7-12 MHz linear array transducer.Results IMT were larger in group A and group B as compared to group C.The distribution of plaque,s echogenicity type were significant difference between group A and group B.Unstable carotid atherosclerotic plaque(78.9%)was the main type of plaque in group A,stable carotid atherosclerotic plaque(71.7%)was the main type of plaque in group B.The plaque surface was major irregularity in group A.There were significant difference in the levels of hs-CRP among group A,group B and group C.Serum hs-CRP level in the unstable atherosclerotic plaques group was higher than that in the stable plaques group,nonplaque group and control group.Conclusion The important relationship existed between unstable atherosclerotic plaques and cerebral infarction.The high plasma levels of hs-CRP was strongly associated with carotid atherosclerosis in patients with cerebral infarction.