急性缺血性脑血管病患者血清ox-LDL 水平与颈动脉斑块的关系

目的：对急性缺血性脑血管病患者血清氧化型低密度脂蛋白（ox‐LDL ）进行研究，并探讨ox‐LDL与颈动脉斑块的稳定性的关系，为ox‐LDL能否作为急性缺血性脑血管病患者的病情及预后评估的一项指标提供依据。方法选取2013年6月～2015年6月该院收治的90例急性脑梗死患者（ACI组）和30例短暂性脑缺血发作患者（TIA组），选取同期我院体检部健康人群100例作为对照组，入选者均均检测血清中ox‐LDL水平。入院当天，按美国国立卫生研究院卒中量表（NIHSS）评分，对轻型、中型、重型患者的ox‐LDL水平进行比较。行颈动脉超声检查，对无斑块、稳定斑块、不稳定斑块组患者的ox‐LDL水平进行比较。结果3组血清ox‐LDL水平比较，差异具有统计学意义（t＝28．20，P＜0．05）。ACI组和TIA组ox‐LDL水平显著性高于对照组（t＝14．36、5．67，P＜0．05）。ACI组ox‐LDL水平显著性高于TIA组（t＝4．56，P＜0．05）。颈动脉无斑块组、稳定斑块组、不稳定斑块组血清ox‐LDL水平比较，差异具有统计学意义（F＝36．69，P＜0．05）。稳定斑块组、不稳定斑块组血清ox‐LDL水平显著性高于无斑块组（t＝6．06、8．67，均 P＜0．05）。不稳定斑块组血清ox‐LDL水平显著性高于稳定斑块组（t＝2．60，P＜0．05）。NIH‐SS分级轻型、中型、重型血清ox‐LDL水平比较，差异具有统计学意义（F＝33．44，P＜0．05）。中型、重型血清ox‐LDL水平均显著性高于轻型（t＝2．75、4．18，均 P＜0．05）。重型血清ox‐LDL水平显著性高于中型（t＝2．13，P＜0．05）。结论急性缺血性脑血管病患者ox‐LDL水平较正常者显著上升，其在一定程度上反映患者颈动脉粥样硬化的程度及神经功能缺损的程度，ox‐LDL可作为急性缺血性脑血管病的血清标记物之一，在评估急性缺血性脑血管病的病情及预后方面有一定的临床意义。

Clinical study and curative effects analysis of OX-LDL level in acute cerebral infarction patients serum

Objective Through analyzing ox‐LDL level in serum of patients with acute cerebral infarction and discussing the re‐lationship between the stability of carotid plaques and the ox‐LDL levels in order to provide the basis for ox‐LDL assessment of the condition and prognosis of acute cerebral infarction .Methods From June 2013 to June 2015 in our hospital 90 cases of patients with acute cerebral infarction(ACI group)and 30 cases of patients with transient ischemic attack (TIA group)were chosen and 100 cases of healthy adults were selected as the control group meanwhile ,which all had ox‐LDL levels in serum testing .At the day of going into hospital ,according to the national institutes of health stroke scale (NIHSS)scores ,patients were divided into the light ,medium , heavy ox‐LDL levels group .Ox‐LDL levels of patients with carotid ultrasound examination ,no plaque ,stable plaques were recorded and compared .Results In the three groups serum ox‐LDL levels all had statistically significant difference (t= 28 .20 ,P< 0 .05) .In the ACI and TIA group ox‐LDL levels were significantly higher than that in the control group (t=14 .36 ,5 .67 ,P< 0 .05) .In the ACI group ox‐LDL levels were significantly higher than that in the TIA group (t= 4 .56 ,P< 0 .05) .In the carotid artery plaque group ,stable plaque group ,the unstable plaque group serum ox‐LDL levels all had statistically significant differences (F=36 .69 ,P< 0 .05) .Stable plaques ,unstable plaque group serum ox‐LDL levels significantly higher than that of no plaque group (t=6 .06 ,8 . 67 ,P< 0 .05) .Of the unstable plaque group serum ox‐LDL levels was significantly higher than that of the stable plaque group (t=2 .60 ,P< 0 .05) .NIHSS grading light ,medium ,heavy ,serum levels of ox‐LDL differences were all statistically significant (F= 33 . 44 ,P< 0 .05) .Medium and heavy serum ox‐LDL levels were significantly higher than that of light (t=2 .75 ,4 .18 ,P< 0 .05) .Ser‐um ox‐LDL levels was significantly higher than that of heavy medium (t=2 .13 ,P< 0 .05) .Conclusion Ox‐LDL levels in patients with acute cerebral infarction have a marked increase compared with the normal group ;To some extent ,it could reflect the degree of carotid atherosclerosis and the nerve function defect ;Ox‐LDL could be used as one of the serum markers of acute cerebral infarc‐tion ,which could assess disease and prognosis in acute cerebral infarction .