颈动脉粥样硬化斑块及相关生化指标与脑梗死的关系  

Relationship between carotid atheromatous plaque and its related biochemical indexes and cerebral infarction

作　　者：夏峰[1] 李美英[1] 曹勇军[1] 苏建华[1] 丁绍青[1] 汤华萍[1] 郑颖炜[1] 

机构地区：[1]安徽省马鞍山市人民医院神经内科,243000

出　　处：《临床神经病学杂志》2004年第3期161-163,共3页Journal of Clinical Neurology

摘　　要：目的　探讨颈动脉粥样硬化斑块及其相关生化指标与脑梗死的关系。方法　对 6 5例脑梗死患者 (脑梗死组 )及 35例非脑梗死患者 (对照组 )分别进行彩色多普勒超声检测 ,并记录两组颈动脉粥样硬化斑块的部位、数目、性质和颈动脉内径 ;同时检测两组的血脂、血糖和纤维蛋白原等生化指标。结果　脑梗死组颈动脉粥样硬化斑块检出率、左右颈总动脉内径 [81 5 4 %、(7 4 3± 0 0 7)mm、(7 5 2± 0 6 0 )mm]与对照组[2 8 5 7%、(7 75± 0 10 )mm、(7 97± 0 75 )mm]比较差异均有显著性 (均P <0 0 5 )。粥样硬化斑块位于颈总动脉最多 (78 2 3% ) ,其次是颈总动脉分叉处 (14 5 2 % ) ,颈内动脉颅外段最少 (7 2 5 % )。斑块部位与脑梗死部位有显著同侧相关性 (P <0 0 5 ) ;脑梗死组三酰甘油 (TG) [(1 81± 0 12 )mmol/L]、餐后 2h血糖 [(9 2 2± 0 4 3)mmol/L]及纤维蛋白原 [(3 18± 0 0 7)mmol/L]也均显著高于对照组 [(1 39± 0 0 9)mmol/L、(8 2 0± 0 35 )mmol/L、(2 6 4± 0 14 )mmol/L](均P <0 0 5 ) ;脑梗死组中颈总动脉内径与TG有显著正相关性 (r=0 34,P <0 0 1) ,与高密度脂蛋白 (HDL)存在显著负相关 (r=- 0 2 5 ,P <0 0 5 )。结论　颈动脉粥样硬化斑块与脑梗死发生有密切关系 。Objective To investigate the relationship between carotid atheromatous plaque and its related biochemical indexes and cerebral infarction.Methods 65 cases with cerebral infarction served as cerebral infarction(CI) group and 35 cases of non-cerebral infarction as control group. In both groups,the location,number and nature of carotid atheromatous plaque and diamete of carotid artery were assessed by Doppler ultrasonography,and the related biochemical indexes such as blood lipid,blood glucose and fibrinogen were evaluated.Results Significant differences of the detectable rate of carotid atheromatous plaque and the diameter of common carotid artery were found between CI group[81.54%,( 7.43± 0.07)mm of left side,(7.52±0.60)mm of right side] and control group[28.57%,(7.75±0.10)mm of left side,( 7.97± 0.75)mm of right side]( P < 0.05). The atheromatous plaques were detected in common carotid artery (78.23%),bifurcation of common carotid artery(14.52%)and extracranial part of internal carotid artery (7.25%) respectively. The location of carotid atheromatous plaque was correlative with cerebral infarction in the same side( P < 0.05). The levels of triglyceride,postprandial blood glucose and fibrinogen in CI group [(1.81±0.12)mmol/L,(9.22±0.43)mmol/L and (3.18±0.07)mmol/L] were obviously higher than those of control group[(1.39±0.09)mmol/L,(8.20±0.35)mmol/L and (2.64±0.14)mmol/L]( P < 0.05). In CI group,the diameter of common carotid artery was positive correlative with triglyceride ( r =0.34, P < 0.01) and negative correlative with high density lipoprotein ( r =0.25, P < 0.05).Conclusion Cerebral infarction is closely related to carotid atheromatous plaque,which is correlative with metabolic disorders such as of triglyceride,high density lipoprotein,blood glucose and fibrinogen. Intervention treatment of carotid atheromatous plaque and its related biochemical indexes are important in clinic.

关 键 词：颈动脉粥样硬化斑块 血脂 血糖 纤维蛋白原 脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]