脑梗死患者颈动脉斑块稳定性及其相关因素分析

目的探讨脑梗死患者颈动脉粥样硬化斑块稳定性及其有关危险因素。方法对139例脑梗死患者行颈部血管超声和血液检查;根据颈部血管超声分为斑块稳定组和不稳定组,比较2组间颈动脉粥样硬化斑块的稳定性及危险因素的差异。结果脑梗死患者颈动脉粥样硬化斑块发生率85.61%,不稳定组血清总胆固醇（CHOL）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、同型半胱氨酸（HCY）、纤维蛋白原（FIB）水平及性别、糖尿病史、吸烟患者比例与稳定组相比差异有统计学意义（P〈0.05）。结论颈动脉粥样硬化斑块与脑梗死密切相关,高水平的CHOL、TG、HCY、FIB,低水平的HDL-C及糖尿病史、吸烟史促使颈动脉粥样硬化斑块演变为不稳定斑块,故积极控制上述危险因素对预防脑梗死发生有重要意义。

Analysis on the risk factors of stability of carotid atherosclerosis plaque in cerebral infarction patients

Objective To explore the risk factors for stability of the carotid artery atherosclerotic plaques in cerebral infarction patients. Methods Color Doppler ultrasound scanner was used to detect the plaques of the carotid arteries in patients with cerebral infarction（n=139）,according to the Doppler ultrasound scanning,the patients were divided into stable plaque group and unstable plaque group.The physical data and the concentrations of total cholesterol（CHOL）,triglycerides（TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）,HCY,fibrinogen（FIB）,blood glucose（GLU）,serum uric acid（SUA）,age and hypertension,diabetes,smoking,sex were measured and compared between the groups. Results Carotid atherosclerotic artery plaques were detected in 85.61% of the patients.When compared with stable plaque group,smoking,male,and diabetes were more frequently found in unstable plaque group,and unstable plaque group were higher concentration of CHOL,TG,HCY and FIB（P0.05）,and HDL-C was lower（P0.05）. Conclusion Carotid atherosclerotic plaques are related to cerebral infarction.Smoking,diabetes mellitus,and high concentration of CHOL,TG,HCY,FIB and low concentration of HDL-C can improve the plaques into unstable plaques,so controlling these risk factors is important to preventing cerebral infarction.