颈动脉斑块积分及炎性因子与脑梗死神经功能缺损的相关性  

Relationship between carotid plaque score and inflammatory factors in patients with cerebral infarction

作　　者：赵梦婷[1] 王红春[1] 石燕清 李永杰[1] 李柔萱[1] 田晖[2] 

机构地区：[1]北京老年医院超声科,北京100193 [2]河北医科大学第二医院超声科,河北石家庄050000

出　　处：《临床荟萃》2017年第6期491-494,共4页Clinical Focus

摘　　要：目的探讨急性缺血性脑梗死(acute cerebral infarction,ACI)患者颈动脉斑块超声表现特点,研究其颈动脉粥样硬化斑块改良Crouse积分及血清C反应蛋白(sensitivity C-reactive protein,CRP)水平与患者神经功能缺损程度(NIHSS评分)的相关性。方法选取2015年7月至2016年11月在北京老年医院收治的经CT或MRI确诊为首发ACI老年患者(ACI组)153例,同期体检健康老年患者(对照组)140例,两组均进行颈动脉超声及血清指标CRP检测。结果 ACI组153例,检出斑块人数140例,检出率91.5%,斑块总数954个;对照组140例,检出斑块人数98例,检出率70%,斑块总数378个,ACI组斑块检出率明显高于对照组(χ~2=22.170,P<0.05)。ACI组斑块形态不规则回声斑块较对照组增多(χ~2=32.270,P<0.05)。ACI组斑块形态主要以混合回声及低回声斑块为主,对照组主要以均质回声及高规则斑块为主,ACI组溃疡斑较对照组也增多(χ~2=343.180,P<0.05)。ACI组血清CRP水平及改良Crouse积分明显高于对照组(χ~2=79.520,P<0.05)。ACI患者中的NIHSS≤7分组及NIHSS>7分组血清CRP水平及颈动脉斑块Crouse积分差异均有统计学意义(χ~2=19.450,P<0.05)。结论 ACI患者不规则斑块及低回声斑块、混合回声斑块均增多,溃疡斑发生率较高,斑块积分及血清CRP增高。随着NIHSS评分增高,ACI患者斑块积分及hs-CRP水平也会增高。Objective To investigate the correlation between the modified Crouse score,serum C reactive protein （CRP）levels and neurological impairment （NIHSS score）in acute cerebral infarction patients.Methods 153 participants who were diagnosed by CT or MRI as the first acute ACI elderly patients were enrolled from Jul.2015 to Nov.2016 in our hospital and the elderly physical examination patients were enrolled as the control group in the same period .The carotid ultrasound and serum CRP were detected in two groups.Results In ACI group,the plaque detection rate was 91.5%（140/153）and the total number of patch was 954.In control group,the detection rate of 70.0% （98/140）and the total number of patch was 378.The plaque detection rate of ACI group was significantly higher than that of control group（χ^2=22.170,P 〈0.05）.The irregular echo plaques of ACI group were increased compared with those of control group （χ^2=32.270,P〈0.05）.The plaque morphology in ACI group was composed with hybrid echo and hypoechoic plaques.However,the plaque morphology in control group was mainly composed with homogeneous echo and hyperechoic plaque,ulcer plaque of ACI group also increased compared with that of control group （χ^2=343.180,P 〈0.05）.The serum CRP and the modified Crouse score in ACI group were significantly higher than those in control group （χ^2=79.520,P 〈0.05）.NIHSS ≤ 7 and NIHSS ＆gt;7 group in CRP level and carotid artery plaque group serum Crouse score differences between groups were statistically significant （χ^2=19.450, P 〈0.05）.Conclusion The number of irregular plaques,hypoechoic plaques and mixed echo patches increased in ACI patients.Moreover,the incidence of plaque,plaque score and serum CRP protein in ACI patients were higher.With the increase of NIHSS score,plaque score and CRP in patients with ACI also increased.

关 键 词：脑梗死 颈动脉 超声检查 斑块 动脉粥样硬化 C反应蛋白质 

分 类 号：R743.33[医药卫生—神经病学与精神病学]