急性脑梗死患者LDL-C、Hcy、Npt、CRP水平的改变及其与颈动脉粥样硬化的关系  

The relationship of the levels of LDL-C,Hcy,Npt,CRP and atherosclerosis in patients with acute cerebral infarction

作　　者：杨西爱[1] 龚家明[1] 刘毅[1] 赵雪[1] 胡德蓉[1] 

机构地区：[1]陕西省安康市中心医院神经内科,725000

出　　处：《疑难病杂志》2015年第11期1111-1114,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨急性脑梗死(ACI)患者低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸(Hcy)、新蝶呤(Npt)、C反应蛋白(CRP)水平的改变及其与颈动脉粥样硬化的关系。方法 2014年6月—2015年6月诊治ACI死患者68例为ACI组,选取同期行健康检查的体检者60例为健康对照组,应用多普勒超声仪测定2组颈动脉内膜中层厚度(IMT),ELISA法测定2组血浆Hcy、Npt,酶直接法测定血浆LDL-C,乳胶免疫比浊法测定CRP。结果 ACI组患者颈动脉斑块发生率为91.17%,显著高于健康对照组10.00%(P<0.05);ACI组血浆LDL-C(4.98±0.89)mmol/L、Hcy(38.96±4.89)μmol/L、Npt(2.45±0.48)ng/ml、CRP(6.89±0.48)mg/L水平高于健康对照组(2.86±0.93)mmol/L、(18.02±3.88)μmol/L、(1.38±0.59)ng/ml、(1.58±0.56)mg/L(P<0.05),而颈动脉IMT(1.85±0.32)mm大于健康对照组(0.42±0.16),差异均有统计学意义(P<0.05)。ACI患者中软斑亚组、混合斑亚组血浆LDLC、Hcy、Npt、CRP水平显著高于硬斑亚组(P<0.05)。经Pearson单因素分析,血浆LDL-C、Hcy、Npt、CRP水平与IMT呈正相关(r=0.412、0.326、0.345、0.369,P<0.05)。结论 ACI合并颈动脉不稳定斑块患者血浆LDL-C、Hcy、Npt、CRP水平显著高于斑块不稳定患者,提示血浆LDL-C、Hcy、Npt、CRP水平可反映ACI患者颈动脉粥样硬化稳定性。Objective To investigate acute cerebral infarction（ACI） patients of low density lipoprotein cholesterol（LDL-C）,homocysteine（Hcy） and neopterin（Npt）,C-reactive protein（CRP） levels and their relationships with carotid atherosclerosis.Methods From June 2014 to June 2015,68 cases of ACI dead patients as ACI group,selected the same period in the hospital for health examination＇s 60 cases of healthy control as control group,two groups of carotid artery intimamedia thickness（IMT） by Doppler ultrasound were measured.ELISA method were used for the determination of 2 groups＇ plasma Hcy and Npt,direct enzymatic were used to measure plasma LDL-C,immuno latex turbidimetric method were used to measure CRP.Results ACI patients＇ carotid artery plaque incidence rate was 91.17%,significantly higher than that in the healthy control group（10.00%,P〈0.05）,ACI group＇s the plasma level of LDL-C was（4.98±0.89） mmol/L,Hcy was（38.96 ±4.89） mol/L Npt was（2.45 ±0.48） ng/ml,CRP was（6.89 ±0.48） mg/L,which were higher than that in the health） control group（2.86 ±0.93） mmol/L,（18.02 ±3.88） μmol/L,（1.38±0.59） ng/ml,（1.58 ±0.56） mg/L,and carotid artery IMT（1.85 ±0.32） mm was greater than that in the healthy control group（0.42 ±0.16） mm,the differences were statistically significant（P〈0.05）.ACI patients＇ soft spot subgroups,mixed plaque subgroups＇ plasma LDL-C,Hcy,Npt and CRP levels were significantly higher than those of the hard plaque subgroups（P〈0.05）.By Pearson univariate analysis,plasma LDL-C,Hcy,Npt,CRP and IMT was positively correlated（r =0.412,r =0.326,r =0.345,r =0.369,P〈0.05）.Conclusion ACI with Carotid plaque instability of plasma LDL-C,Hcy,Npt,CRP levels were significantly higher than the unstable plaque group,suggesting that plasma LDL-C,Hcy,Npt,CRP levels may reflect the level of the carotid artery in patients with ACI atherosclerosis stability.

关 键 词：脑梗死 急性 低密度脂蛋白胆固醇 同型半胱氨酸 新蝶呤 C反应蛋白 内膜中层厚度 

分 类 号：R743.33[医药卫生—神经病学与精神病学]