颈动脉狭窄程度及血浆髓过氧化物酶水平对缺血性脑卒中的影响

目的：分析不同颈动脉狭窄程度、不同血浆髓过氧化物酶（myeoloperoxidase，MPO）水平对狭窄侧颈动脉供血区发生缺血性脑卒中的影响。方法：对颈部血管彩色超声证实的120例单侧颈动脉狭窄病变行头颅CT扫描，以明确每个病例狭窄侧颈动脉供血区中有无梗死灶。将病例分为MPO水平升高组（n=57）和正常组（n=63），分析两组中梗死灶发生率的差异。根据颈部血管彩色超声检查测量值计算狭窄程度，将上述病例按狭窄程度又分为≤50％组（n=68）、51％～69％组（n=36）和≥70％组（n=16），分析狭窄程度与病变同侧梗死灶发生率的关系，同时分析相同狭窄程度时不同MPO水平与梗死灶发生率的关系。结果：MPO升高组57例中，有梗死灶的患者为43例，占75．43％；MPO正常组63例中，有梗死灶者33例，占52．38％；两组间梗死灶的发生率差异有统计学意义（P〈0．05）。狭窄程度≤50％组、51％～69％组和≥70％组梗死灶的发生率分别为63．23％，63．89％和62．50％，三组间差异无统计学意义（P〉0．05）。颈动脉狭窄程度≤50％组的68例中，MPO升高32例，正常36例，分别有26例（26／32，81．25％）和17例（17／36，47．22％）发生梗死灶，梗死灶的发生率差异有统计学意义（P〈0．05）。结论：在颈动脉狭窄病例中，MPO升高组在狭窄侧颈动脉供血区发生缺血性脑卒中的风险较MPO正常组更大，而颈动脉狭窄程度与缺血性脑卒中无明显关系。

Effect of carotid stenosis degree and plasma myeoloperoxidase level on cerebral ischemic stroke

Objective： To explore the effect of carotid stenosis degree and plasma level of myeoloperoxidase （MPO） on the occurrence of cerebral ischemic stroke. Methods： A total of 120 patients with carotid stenosis confirmed by carotid artery ultrasound were included. Computer tomography scan was performed to identify if there was infarction in all patients. Xhese patients were divided into a high MPO group （n=57） and a normal MPO group （n=63） according to the plasma MPO level, and the incidence of cerebral infarction was compared in the 2 groups. Meanwhile, all patients were also divided into 3 groups according to the degree of carotid stenosis： the low degree ofstenosis group （ ≤ 50%, n=68）, the medium degree of stenosis group （51%-69%, n=36） and the high degree of stenosis group （ ≥ 70%, n=16）. The correlation between the carotid stenosis degree and the incidence of ipsilateral cerebral infarction was analyzed. If the carotid stenosis degree was same, the relationship between the plasma MPO levels and the incidence of cerebral infarction was determined. Results： In 57 patients of the high MPO group, 43 patients suffered infarction （75.43%）, while in the 63 patients of the normal MPO group, only 33 displayed infarction （52.38%）. The difference between these two groups was significant （P〈0.05）. The incidences of cerebral infarction were 63.23%, 63.89%, and 62.50% in the low, medium and high degree of stenosis group, respectively. The difference among these three groups was not significant （P〉0.05）. In the 68 patients of the low degree of stenosis group, the MPO level was increased in 32 patients and normal in 36 patients. Among them, 26 patients （26/32, 81.25%） and 17 patients （17/36, 47.22%） showed infarction, respectively, with significant difference （P〈0.05）. Conclusion： In the patients with carotid stenosis, the risk of cerebral ischemic stroke in patients with elevated MPO level was higher than that with the normal MPO level. However, there was no significant correlation between the carotid stenosis degree and the occurrence of cerebral ischemic stroke.