进展与非进展型脑梗死患者CT血管造影及血清C反应蛋白、同型半胱氨酸、纤维蛋白原、D-二聚体水平比较分析  

Comparative analysis of CT angiography and serum C-reactive protein, homocysteine, fibrinogen, D-dimer levels between patients with progressive and non-progressive cerebral infarction

作　　者：蓝玉[1] 周少旦 钟良 李宁[1] 韦馨娴 韦英海[1] LAN Yu;ZHOU Shaodan;ZHONG Liang;LI Ning;Wei Xinxian;WEI Yinghai(Department of Neurology,the Affiliated Ethnic Hospital of Guangxi Medical University&the Ethnic Hospital of Guangxi Zhuang Autonomous Region,Nanning 530001,China)

机构地区：[1]广西医科大学附属民族医院/广西民族医院神经内科

出　　处：《内科》2019年第6期636-639,共4页Internal Medicine

基　　金：崇左市科技计划项目(崇科17111318)

摘　　要：目的比较进展性脑梗死(PCI)与非进展型脑梗死(NPCI)患者头颈部CT血管造影(CTA)及血清C反应蛋白(CRP)、同型半胱氨酸(Hcy)、纤维蛋白原(FIB)、D-二聚体(D-D)水平。方法回顾性分析173例前循环性急性脑梗死患者的临床资料,按病情将患者分为PCI组(56例)与NPCI组(117例),比较两组患者CTA所示头颈部血管狭窄程度、斑块性质;比较两组患者入院时、入院第3天血清CRP、Hcy、FIB、D-D水平。结果 PCI组患者的动脉狭窄发生率(92.9%)显著高于NPCI组(55.6%),头颈部动脉狭窄中重度所占比例显著大于NPCI组,差异有统计学意义(P<0.05)。PCI患者不稳定性斑块所占比例、软斑块及混合斑块所占比例均显著高于NPCI组,差异有统计学意义(P<0.05)。入院时,两组患者的血清CRP、Hcy、FIB、D-D水平比较差异无统计学意义(P>0.05);入院第3天,PCI组患者的血清CRP、Hcy、FIB、D-D水平均显著高于NPCI组,差异有统计学意义(P<0.05)。结论 PCI与患者头颈部动脉狭窄程度及斑块的性质密切相关,患者血清CRP、Hcy、FIB、D-D水平早期明显升高,CTA检查及上述血清指标检测结果可作为早期筛查PCI患者的重要依据。Objective To compare the CT angiography(CTA) of head and neck and the levels of C-reactive protein(CRP), homocysteine(Hcy), fibrinogen(FIB) and D-dimer(D-D) between patients with progressive cerebral infarction(PCI) and non-progressive cerebral infarction(NPCI). Methods Clinical data of 173 patients with anterior circulation acute cerebral infarction were analyzed retrospectively. Patients were divided into PCI group(56 cases) and NPCI group(117 cases) according to disease condition. The degree of head and neck vascular stenosis and plaque properties were compared between the two groups. The levels of serum CRP, Hcy, FIB and D-D at the time of admission, and on the 3 rd day of admission were compared between the two groups. Results Compared to the NPCI group, patients in the PCI group obtained a higher incidence of artery stenosis(92.9% vs. 55.6%), and a larger proportion of moderate to severe artery stenosis in head and neck, with the statistically significant differences(P<0.05). The proportion of unstable plaque, soft plaque, and mixed plaque in the PCI group was higher than those in the NPCI group, and the differences were statistically significant(P<0.05). At the time of admission, there were no statistically significant differences in serum CRP, Hcy, FIB and D-D levels between the two groups(P>0.05);while the serum CRP, Hcy, FIB and D-D levels of the PCI group 3 days after admission were higher than those of the NPCI group, with the statistically significant differences(P<0.05). Conclusion PCI is closely related to the degree of head and neck artery stenosis and the plaque properties in patients. The serum CRP, Hcy, FIB, and D-D levels increase significantly in the early stage of PCI, for the CTA examination combined with the results of the abovementioned serum indicators can be used as an important basis for early screening of PCI patients.

关 键 词：进展性脑梗死 CT血管造影 C反应蛋白 同型半胱氨酸 纤维蛋白原 D-二聚体 

分 类 号：R543.5[医药卫生—心血管疾病]