脑梗死患者颈动脉斑块与血白细胞、血脂、纤维蛋白原水平的关系  

Relationship between carotid atherosclerotic plaque and white blood cell,levels of plasma lipid,fibrinogen in the patients with cerebral infarction

作　　者：沈丽华[1] 柯开富[1] 顾晓苏[1] 吴二兵[1] 陈翔[1] 

机构地区：[1]南通大学附属医院神经内科,226001

出　　处：《临床神经病学杂志》2009年第2期139-141,共3页Journal of Clinical Neurology

摘　　要：目的研究脑梗死患者颈动脉粥样硬化斑块与血白细胞(WBC)、血脂及纤维蛋白原(Fib)水平的关系。方法对38例脑梗死患者行颈动脉MRI检查,以发现动脉粥样硬化斑块并确定性质;检测脑梗死患者和31名健康体检者(正常对照组,彩色多普勒超声检查排除颈动脉斑块)的WBC、血脂水平[包括总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白(LDL)、载脂蛋白(a)]和Fib水平。结果26例(68.4%)脑梗死患者有颈动脉斑块,12例(31.6%)无斑块;其中不稳定斑块20例(52.6%),稳定斑块6例(15.8%)。脑梗死组(无斑块组、稳定斑块组和不稳定斑块组)的血Fib水平均明显高于正常对照组(均P<0.01);不稳定斑块组的血WBC和LDL水平显著高于正常对照组(均P<0.05),其他各项的差异均无统计学意义。结论血WBC和LDL水平可能与颈动脉不稳定斑块并发的脑梗死有关;血浆高Fib水平可促进脑梗死的发生。Objective To study the relationship between carotid atherosclerotic plaque and white blood cell （ WBC）, levels of plasma lipid, fibrinogen （Fib） in the patients with cerebral infarction（CI）. Methods 38 patients with CI were examined on carotid arteries using magnetic resonance imagine （ MRI ） to discover the atherosclerotic plaques and ascertain their stability . WBC, the levels of plasma lipids [ including total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein （LDL）, lipoprotein （a）] and Fib were detected in CI patients and 31 healthy subjects （ normal control group, all subjects were examined carotid arteries with color dopper uhrasonography and no plaques were found） ]. Results 26 patients with CI （68.4 % ） showed carotid plaques and 12 patients with CI（ 31.6% ）did not. Of these, the patients with unstable versus stable plaque were 20 （52.6%） versus 6 （15.8%） respectively. The levels of plasma Fib in the CI group （ including CI without plaque, CI with stable plaque and CI with unstable plaque） were significantly higher than that in the normal control group（ all P 〈0. 01 ） . Both WBC and LDL level in CI with unstable plaque group were obviously higher than those in the normal control group （ all P 〈 0. 05 ）. There was no statistical difference in other examinal resauhs between CI group and normal control group. Conclusions The WBC and level of plasma LDL may concern with the development of CI second to unstable carotid atherosclerotic plaque. The high level of plasma Fib can contribute to CI.

关 键 词：脑梗死 颈动脉粥样硬化斑块 血白细胞 血脂 纤维蛋白原 

分 类 号：R743.32[医药卫生—神经病学与精神病学]