症状性颈动脉狭窄与纤维蛋白原水平相关研究  

Research on relation between symptomatic carotid stenosis and fibrinogen level

作　　者：王连芹 魏玉清 宁海春 李国锋 殷海卿 彭红兵 李俊青 韩雪 

机构地区：[1]邢台市第三医院脑血管病治疗中心,河北邢台054000

出　　处：《临床荟萃》2011年第20期1765-1767,共3页Clinical Focus

基　　金：河北省2010年科学技术研究与发展计划项目(10276105D-30)

摘　　要：目的探索症状性颈动脉狭窄与"新"的危险因素纤维蛋白原(Fib)水平的关系,为症状性颈动脉狭窄发生发展的防治提供依据。方法以颈动脉彩色多普勒超声或CT血管造影(CTA)或数字减影血管造影(DSA)显示颈动脉狭窄≥50%为依据,将急性缺血性脑血管病(ICVD)患者315例随机分为两组:症状性颈动脉狭窄患者(狭窄组)173例;颈动脉无狭窄或狭窄<50%无责任症状患者(对照组)142例。检测两组Fib、血糖和血脂水平等,按照Fib值分4个水平(Fib<2.90g/L,2.91～3.40g/L,3.41～4.00g/L,>4.01g/L)观察颈动脉狭窄≥50%的发生率。同时进行多因素logistic回归分析。结果狭窄组Fib水平和Fib水平异常者的比例明显高于对照组(P<0.01)。随着Fib值的升高,血管狭窄≥50%患者的比例逐渐增加(P<0.01)。Fib水平升高是症状性颈动脉狭窄独立而作用最强的危险因素(OR=1.495,95%CI=1.195～2.887,P<0.01)。结论 Fib升高与症状性颈动狭窄程度密切相关,作用可能强于传统危险因素。为防治ICVD、调治Fib提供了依据。Objective Exploring the relationship between the symptomatic carotid stenosis and the new risk factor fibrinogen（Fib） level,to provide the basis for the occurrence and development of the symptomatic carotid stenosis. Methods Acute ischemic cerebrovascular disease（ICVD） patients（315 cases） were randomly divided into two groups by carotid artery color Dopplar ultrasound or CT angiography（CTA） or digital subtraction angiography（DSA） showing the carotid artery stenosis acuity 50% as the basis.The two groups included the experimental group（symptomatic carotid stenosis patients,173 cases） and the control group（no carotid stenosis or the stenosis50% and no obligation to patients with symptoms,142 cases）.The level of Fib,blood glucose and blood lipid and others were detected in two groups.The incidence of carotid stenosis≥50% by the four levels of（Fib2.90 g/L,2.91-3.40 g/L,3.41-4.00 g/L,4.01 g/L） were observed,and then,the data were analyzed by logistic regression analysis. Results Fib level and the proportion for the patients with abnormal Fib level in experimental group were significantly higher than those in control group（P0.01）.With the rise of Fib level,the proportion increased significantly for patients with angiostegnosis ≥50%（P0.01）.The rise of Fib level was an independent and the strongest function risk factor for symptomatic of carotid stenosis（OR=1.495,95%CI=1.195-2.887,P0.01）. Conclusion Fib rise is closely related to symptomatic carotid stenosis,and the effect may be stronger than the traditional risk factors.The study provides the basis of the prevention and treatment for acute ICVD in lowering Fib level.

关 键 词：颈动脉狭窄 脑缺血 诊断显像 纤维蛋白原 危险因素 

分 类 号：R543.4[医药卫生—心血管疾病]