急性脑梗死患者血清促动脉硬化指数与颈动脉内膜中层厚度及氧化型低密度脂蛋白水平的研究  

A study of atherogenic index of plasma,carotid intima-media thickness,and level of oxidized low-density lipoprotein in patients with acute cerebral infarction

作　　者：王龙[1] 赵学敏[1] 袁肖征 胡中文[1] 邓奇[1] 牛振[1] 王复郁 

机构地区：[1]皖北煤电集团总医院/蚌埠医学院第三附属医院神经内科,安徽省宿州市234000 [2]皖北煤电集团总医院/蚌埠医学院第三附属医院药剂科,安徽省宿州市234000

出　　处：《国际神经病学神经外科学杂志》2016年第5期447-450,共4页Journal of International Neurology and Neurosurgery

摘　　要：目的探讨急性脑梗死(ACI)患者血清氧化型低密度脂蛋白(ox-LDL)、促动脉硬化指数(AIP)水平与颈动脉粥样硬化的关系。方法连续性选取ACI患者120例作为研究对象,选择同期健康体检者60例作为对照组。分别检测两组的ox-LDL水平及血浆脂质代谢水平,后者包括甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C),并计算血浆促动脉硬化指数(AIP)。对ACI组患者进行颈部血管彩超检查,根据检查结果将其分为颈动脉内膜中层厚度(IMT)正常组(11例)、IMT增厚组(25例)和颈动脉粥样斑块形成(CAS)组(84例),比较各组ox-LDL和AIP水平。结果与对照组相比,ACI组斑块检出率、易损斑块检出率明显增高(P<0.01);ACI组血清ox-LDL与AIP明显升高(P<0.01)。在ACI患者中,CAS组血清ox-LDL及AIP较IMT增厚组明显增高(P<0.01);IMT增厚组血清ox-LDL及AIP高于IMT正常组(P<0.01,P<0.05)。Pearson检验结果显示,ox-LDL水平与IMT水平呈正相关(r=0.720,P<0.01);AIP值与IMT水平呈正相关(r=0.717,P<0.01);血清AIP与ox-LDL水平之间有相关性(r=0.655,P<0.01)。结论 ox-LDL和AIP与颈动脉粥样硬化形成、发展及急性脑梗死发生有密切关系。两者联合测定能够更全面评估缺血性脑卒中发生的风险。Objective To explore the relationship of carotid atherosclerosis with serum level of oxidized low-density lipoprotein （ ox- LDL） and atherogenic index of plasma （AIP） in patients with acute cerebral infarction （ACI）. Methods One hundred and twenty patients with ACI were consecutively enrolled as subjects. Sixty healthy people within the same period were used as controls. The level of ox-LDL, plasma lipid metabolism, and AIP were evaluated in the two groups. The plasma lipid metabolism was characterized with the levels of triglycerides （TG）, low-density lipoprotein （LDL-C）, and high-density lipoprotein （HDL-C）. The ACI group was divided into normal carotid intima-media thickness （IMT） group （ n = 11 ）, large IMT group （ n = 25 ）, and carotid atherosclerosis （CAS） group （n = 84） according to the results of carotid artery sonography. The level of ox-LDL and AIP were compared between the three groups. Results Compared with the control group, the ACI group had significantly higher detection rates of plaque and vulnerable plaque, a significantly higher level of ox-LDL, and a significantly higher AIP （all P 〈 0.01 ）. In patients with ACI, the CAS group had significantly higher serum level of ox-LDL and AIP than the large IMT group （all P 〈0.01 ）, while the large IMT group had significantly higher serum level of ox-LDL and AIP than the normal IMT group （P 〈0.01, P 〈0.05）. The Pearson analysis showed that IMT was positively correlated with the ox-LDL level and AIP （r = 0.720, P 〈 0.01 ; r = 0.708, P 〈 0.01 ）, while the ox-LDL level was correlated with AIP （ r = 0.655, P 〈 0.01 ）. Conclusions ox-LDL and AIP are closely related to the formation and development of CAS and the incidence of ACI. The combined measurement of the two indices provides a comprehensive assessment of the risk of ischemic stroke.

关 键 词：脑梗死 动脉粥样硬化 氧化应激 氧化型低密度脂蛋白 促动脉硬化指数 

分 类 号：R743.3[医药卫生—神经病学与精神病学]