鼻咽癌放射治疗后脑损伤患者HCY和hs-CRP水平与颈动脉狭窄的关系  

The study on relationship between levels of HCY, hs-CRP and carotid stenosis in patients with radiation brain injury of nasopharyngeal carcinoma

作　　者：黎捷 卢奎[2] 朱玉亮[3] 潘军利[2] LI Jie LU Kui ZHU Yu-liang et al

机构地区：[1]广州市增城区人民医院神经内科,广东广州511300 [2]中山市人民医院神经内科,广东中山528403 [3]中山市人民医院肿瘤放疗科,广东中山52840

出　　处：《中国医学装备》2016年第10期58-61,共4页China Medical Equipment

基　　金：广东省医学科研基金(B2014445)"CORM-3介导小胶质细胞P38抑制VCAM-1治疗放射性脑损伤"

摘　　要：目的:探讨鼻咽癌放射治疗后脑损伤患者血清同型半胱氨酸(HCY)、高敏C反应蛋白(hsCRP)与发生颈动脉狭窄之间的关系。方法:选取119例鼻咽癌放射治疗后脑损伤患者,将其纳入放疗脑损伤组;以同期未经放射治疗的56例鼻咽癌患者作为对照组。采用颈部血管超声检测,并比较两组患者颈动脉内膜中层厚度(CIMT)、斑块检出率及颈动脉狭窄率。将放射治疗脑损伤组再分为无狭窄组、轻度狭窄组、中度狭窄组及重度狭窄组;分别检测各组HCY和hs-CRP水平。结果:放射治疗脑损伤组与对照组CIMT值分别为(1.12±0.29)mm和(0.78±0.23)mm,两组比较有差异(t=4.412,P<0.05);放射治疗脑损伤组斑块检出率和颈动脉狭窄率均较对照组显著升高,两组比较差异显著(x^2=17.26,x^2=16.47;P<0.05)。放射治疗脑损伤组伴颈动脉狭窄患者的HCY和hs-CRP均较无狭窄组显著升高,重度狭窄组HCY水平为(16.73±5.63)μmol/L,较轻度狭窄组明显增高,差异显著(F=14.14,P<0.05);中度、重度狭窄组hs-CRP水平分别为(4.21±0.64)mg/L和(5.31±0.86)mg/L,均较轻度狭窄组升高,且有差异(F=320.90,P<0.05)。结论:头颈部放射治疗是颈动脉斑块形成及狭窄发生的危险因素;HCY及hs-CRP是反映鼻咽癌放射治疗后颈动脉狭窄程度的预测因素。Objective Aimed to explore the relationship between serum homocysteine（HCY）, high sensitivity C-reactiveprotein（hs-CRP）and carotid stenosis in patients of radiation brain injury of nasopharyngeal carcinoma. Methods：119 patients with RBI of nasopharyngeal carcinoma were collected in RBI group. The control group contained 56patients of nasopharyngeal carcinoma who had not received radiotherapy. Neck vascular ultrasound was used todetect and compare carotid intima media thickness（CIMT）, rates of plaque formation and carotid stenosis. The RBIgroup were divided into no stenosis, mild, moderate and severe stenosis groups. The serum homocysteine and highsensitivity C-reactive protein levels were detected. Results： RBI group had significantly increases （t=4.412, P〈0.05）of CIMT（1.12±0.29）mm compared with control group（0.78±0.23）mm, as which rates of plaque formation and carotidstenosis had obviously higher compared with control group（x2=17.26, x2=16.47, P〈0.05）. In RBI groups, the HCY andhs-CRP level of various degree of stenosis was higher than no stenosis group. The severe stenosis group had significanthigher level（16.73±5.63 μmol/L） of HCY level than mild stenosis group（F=14.14, P〈0.05）. The hs-CRP levels ofmoderate stenosis group（4.21±0.64） mg/L and severe stenosis group（5.31±0.86）mg/L were both higher than mildstenosis group（F=320.90, P〈0.05）. Conclusion： Radiotherapy is a risk factor of plaque formation and carotid stenosis.The HCY and hs-CRP level are predictors of degree of carotid stenosis after radiotherapy of nasopharyngeal carcinoma.

关 键 词：鼻咽癌 放射治疗 颈动脉狭窄 超敏C反应蛋白 同型半胱氨酸 

分 类 号：R816.96[医药卫生—放射医学]