急性脑梗死患者血清超敏CRP水平变化与颈动脉斑块特点的研究

目的:探讨急性脑性梗死患者血清超敏C-反应蛋白(hs-CRP)水平变化及颈动脉斑块的特点。方法:将112例急性脑梗死患者分为老年组和青年组、腔隙性梗死组和非腔隙性梗死组、进展性卒中和非进展性卒中组、吸烟组和非吸烟组,采用全自动生化分析仪测定患者血清中hsCRP水平,并应用颈动脉超声对斑块特点进行分析。结果:老年组、进展型卒中组、非腔隙性梗死组、吸烟组与青年组、稳定型卒中组、腔隙性梗死组和非吸烟组相比,前者hsCRP值显著高于后者,差异均有统计学意义(均P<0.01)。颈动脉超声显示有斑块患者73例(65.18%),共检出斑块230块,斑块绝大部分(79.56%)位于颈总动脉。随着年龄的增加,超声检出的斑块数相应增多。斑块以中回声斑块为主,青年组以中低回声斑块为主,老年组以混合回声斑块为主,其余各组斑块回声信号差异无统计学意义(均P>0.05)。青年组在颈内动脉起始部发现斑块明显高于老年组(P<0.01)。结论:急性脑梗死时,年龄、梗死面积愈大,病情愈不稳定,hsCRP水平愈高。颈动脉超声通过描述斑块的声学特征,间接反映了斑块的稳定性。

Study on Changes of Serum hs-CRP Level and Features of Carotid Plaques in Patients with Acute Cerebral Infarction

Objective: To investigate the relationship between changes of the serum high sensitive C-reactive protein (hs-CRP) level and the features of carotid plaques in patients with acute cerebral infarction. Methods: One hundred and twelve patients with acute cerebral infarction were divided into 8 groups (elder,youth,lacunar infarction,non-lacunar infarction,stable,unstable,smoke and non-smoke groups). The levels of serum hs-CRP were detected by automatic biochemical analyzer. The features of carotid plaques were analyzed by carotid artery ultrasound. Results: The levels of hs-CRP were significantly increased in elder,unstable,non-lacunar infarction and smok groups compare with that of youth,stable,lacunar infarction and non-smok groups(P < 0.01). The results of carotid ultrasound showed that 73 patients(65.18%) had plaques. Most of the plaques(79.56%) were located in common carotid artery. The more plaques were detected with age. Most of plaques were moderate echogenicity. It was found that plaques were moderate and hypoechogenicity in youth group,but plaques were mixed echogenicity in old group. There were significantly more plaques at the beginning of the internal carotid artery in youth group compared with those in the elder group. Conclusion: In patients with acute cerebral infarction,the older the age,the bigger the size of the infarction and the more unstable the cases will be,the higher the level of hs-CRP. Carotid artery ultrasound represented the acoustic features of the plaques,which reflected the stability of the plaques indirectly.