颈动脉狭窄程度及血hs-CRP水平对缺血性脑血管事件的影响  

The effects of carotid stenosis degree and blood hs-CRP levels on ischemic cerebrovascular events

作　　者：吕向洋[1] 孙可健[1] 帅杰[1] 

机构地区：[1]第三军医大学新桥医院神经内科,重庆400037

出　　处：《中国神经精神疾病杂志》2012年第8期490-493,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的通过颈部血管彩色超声(carotid ultrasound)、计算机断层扫描(computer tomography,CT)、血超敏-C反应蛋白(high sensitivity C-reactive protein,hs-CRP)水平测定分析不同颈动脉狭窄程度,探讨不同hs-CRP水平对狭窄侧颈动脉供血区发生缺血性脑血管事件的影响。方法颈部血管彩色超声证实的114例单侧颈部血管狭窄病变,行头颅CT以明确狭窄侧颈动脉供血区中有无梗死灶。通过血hs-CRP水平测定,将病例分为hs-CRP水平升高组和正常组,分析两组中梗死灶发生率的差异。通过颈部血管彩色超声检查测量值计算狭窄程度,将狭窄程度分为≤50%,50%～70%及≥70%三个级别,分析狭窄程度与病变同侧梗死灶发生的相关性,同时分析相同狭窄程度时不同hs-CRP水平与发生梗死灶的相关性。结果 hs-CRP升高组51例,其中有梗死灶的为37例;hs-CRP正常组病例共63例,其中有梗死灶的为33例;两组间梗死灶的发生率具有统计学差异(72.55%对52.38%P=0.028)。颈动脉狭窄程度≤50%有62例,50%～70%有36例,≥70%有16例,三个级别狭窄程度中梗死灶的发生率分别为59.68%、63.89%、62.50%,三组间无统计学差异(P>0.05)。颈动脉狭窄程度≤50%的62病例中,hs-CRP升高26例,正常36例,分别有20例和17例发生梗死灶,梗死灶的发生率具有统计学差异(76.92%对47.22%,P=0.019)。结论针对动脉粥样硬化颈动脉狭窄病例,hs-CRP升高组在狭窄侧颈动脉供血区发生缺血性脑血管事件的风险较hs-CRP正常组更大。Objective To investigate the effects of carotid stenosis degree and serum level of high sensitivity C- reactive protein （hs-CRP） on the occurrence of isehemie eerebrovascular events, and to evaluate the risk factors for is- chemic cerebrovascular events. Methods One hundred and fourteen cases with carotid stenosis confirmed by coratid ultrasound were included in present study. Computer tomography scan was performed to examine cerebral infarction in all patients. The patients were divided into high hs-CRP group and normal hs-CRP group according to the serum hs-CRP levels, and each group was subdivided into three subgroups on the basis of the carotid stenosis degree （ ≤ 50%, 50%- 70%,≥70%）. Results The incidence rate of cerebral infarction was significantly higher in high hs-CRP group （37/ 51, 72.55%） than in normal hs-CRP group （33/63, 52.38%）. The occurrence rates were 59.68% in carotid stenosis of ≤50%, 62.50% in carotid stenosis of 50%-70%, 63.89% in stenosis of ≥70%. there were no significant differences in cerebral infarction occurrence rates among the groups with different degree of carotid stenosis, In the lower carotid steno- sis degree group （≤50%）, patients with high hs-CRP levels had higher incidence of cerebral infarction compared with those with normal hs-CRP levels （P 〈 0.05）. Conclusion High serum hs-CRP levels but not carotid stenosis degree are the risk factors for the occurrence of ischemic cerebrovascular events in patients with carotid stenosis.

关 键 词：颈动脉狭窄 超敏C反应蛋白 脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]