主动脉粥样斑块稳定性与粘附分子相关性研究  

Association between Atherosclerosis Plaques and Serum Soluble Adhesive Molecules Level in Cerebral Infarction Patients

作　　者：黄玉宇[1] 陆建荣[1] 闻应时[1] 刘文华[2] 顾承志[2] 黄怀宇[2] 高勇[3] 

机构地区：[1]江苏省靖江市中医院彩超室,214500 [2]江苏省南通大学第二附属医院神经内科,226001 [3]江苏省南通大学第二附属医院彩超室,226001

出　　处：《实用全科医学》2007年第12期1042-1043,共2页Applied Journal Of General Practice

基　　金：江苏省卫生厅重点攻关课题(H200217)

摘　　要：目的探讨脑梗死主动脉粥样硬化斑块及其稳定性与可溶性粘附分子的相关性。方法脑梗死患者87例,根据入院主动脉彩超检查情况分为两大组:主动脉粥样斑块阴性组及阳性组,后组又根据经颅多普勒超声(TCD)微栓子信号(MES)检测情况分为MES阴性组和MES阳性组。比较3组入院时可溶性粘附分子水平,并对MES阳性组予低分子肝素钠(LWMH)等干预治疗,分别于治疗前,治疗后1周、2周、4周检测可溶性粘附分子水平。结果各组可溶性粘附分子入院时均偏高,主动脉粥样斑块阳性的2组明显高于阴性组(P<0.01),且MES阳性组较阴性组也有明显增高(P<0.05);MES阳性组干预治疗后可溶性粘附分子呈下降趋势,于第2周达低峰,但第4周又有上升。结论主动脉粥样斑块的形成及破裂与可溶性粘附分子密切相关,可溶性粘附分子可作为脑梗死病情变化的监测指标,在老年人群中尝试常规抗炎治疗为防治脑梗死拓宽了思路。Objective To evaluate the association between aorta atheromatous plague and the level of serum soluble adhesive molecules in cerebral infarction patients. Methods According to the results of aorta atheromatous plague explored With carotid artery ultrasound at hospitalization,87 patients [ 49 males,38 females, range 44 to 79 years old and average （59± 18 ） years old ] with cerebral infarction were divided into two main groups： Aorta atheromatous plague negative group and aorta atheromatous plague plaque positive group. Aorta atheromatous plague positive group were divided into two subgroups according to the results of microembelic signals（MES） detected by transcranial doppler（TCD）, i. e. MES negative group and MES positive group. Serum soluble adhesive molecules levels were measured by radioimmunoassay at hospitalization and were compared between every two groups. In MES positive group, the patients were treated with low molecular heparin sodium （LWMH）. The serum soluble adhesive molecules levels were measured before therapy and at the end of the lst,2nd,4th week after treatment respectively. Results The levels of serum soluble adhesive molecules in all groups were beyond the reference. The levels of serum soluble adhesive molecules in MES negative group and MES positive group were higher（ P 〈 0.01 ）than which in aorta atheromatous plague negative group. Serum soluble adhesive molecules levels were higher in MES positive group than in MES negative group（ P 〈 0.05 ）. In MES positive group, serum soluble adhesive molecules levels tended to decrease after the treatment with LWMH. It reached the lowest point at the end of the 2nd. week, and then it increased at the end of the 4th week. Conclusions The formation and cracking of the aorta atheromatous plague may be associated with the serum soluble adhesive molecules. The level of serum soluble adhesive molecules may be an index in monitoring the state of cerebral infarction. Applying anti-inflammation therapy routinely in older populatio

关 键 词：脑梗死 主动脉粥样硬化斑块 微栓子信号 可溶性粘附分子 

分 类 号：R543.1[医药卫生—心血管疾病]