血浆纤维蛋白原水平与脑大动脉狭窄的相关分析  

Association between plasma fibrinogen level and severity of cerebral large-artery stenosis

作　　者：陈月富[1] 代成波[2] 王硕[2] 马桂贤[2] 张雄[2] 王丽娟[2] 

机构地区：[1]广东省心血管病研究所,广州510080 [2]广东省人民医院神经内科广东省医学科学院

出　　处：《中华老年心脑血管病杂志》2009年第7期512-514,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：广东省自然科学基金项目(8151008004000008);广州市科技计划项目(200621-Z0112)

摘　　要：目的探讨血浆纤维蛋白原（Fib）水平与脑大动脉狭窄程度的相关性。方法选择行全脑数字减影血管造影术（DSA）检查的急性缺血性脑卒中患者317例，根据DSA显示动脉狭窄是否≥50％为依据，分为两组：狭窄组（174例）患者颅内、外脑大动脉至少1支血管狭窄≥50％；对照组（143例）患者无狭窄或血管狭窄〈50％。检测两组血浆Fib及血脂水平等．按Fib值分4个水平（Fib〈2．96g／L，Fib2．96～3．47g／L，Fib3．48～4．06g／L，Fib〉4．06g／L）观察血管狭窄≥50％的发生率。进行多元逐步logistic回归分析。结果狭窄组血浆Fib水平和Fib水平异常患者的比例明显高于对照组（P〈0．05）。随着Fib值的升高，血管狭窄≥50％患者的比例显著增加（X^2=23．10，P=0．000）。血浆Fib水平升高是脑大动脉粥样硬化狭窄独立的、且作用最强的危险因素（OR=1．558，95％CI：1．164～2．087，P=0．003）。结论Fib升高与脑大动脉狭窄程度密切相关，其作用可能强于其他传统危险因素。Objective To investigate the association between plasma fibrinogen（Fib） level and severity of cerebral large-artery atherosclerotie stenosis in patients with cerebral ischemic stroke. Methods 317 patients with ischemic stroke undergoing cerebral angiography（DSA） were studied. All patients were divided into two groups according to the findings of DSA. Stenosis group （n = 174） included patients with large-artery atherosclerotic stenosis（stenosis≥50%, at least one of large arteries） ,and control group （n = 143） included patients without artery stenosis or mild stenosis（stenosis,〈50%）. Results The Fib levels in large-artery atherosclerotic stenosis group were higher than those in control group,and rate of abnormal plasma Fib level（Fib〉4.0 g/L） in large-artery atherosclerotic stenosis group（36.78%） was also higher than that in control group （15.38%）. The with the plasma rate of large-artery atherosclerotic stenosis （stenosis≥ 50%） increased gradually level of the Fib （X^2 = 23.10,P = 0. 000）. Multivariate stepwise logistic regression analysis showed that plasma Fib level was an independent and strong risk factor for cerebral large artery atherosclerotic stenosis （OR = 1. 558,95% CI： 1. 164--2. 087, P = 0. 003）. Conclusions The elevated plasma Fib was significantly correlated with the severity of cerebral large-artery atherosclerosis,and may play a more important role than other traditional risk factors.

关 键 词：脑缺血 动脉硬化 脑血管意外 纤维蛋白原 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]