急性缺血性脑卒中患者血清氧化型低密度脂蛋白水平与颈动脉易损斑块的关系

发布时间：2019-02-23 09:20

【摘要】：目的探讨急性缺血性脑卒中患者血清氧化型低密度脂蛋白(ox-LDL)水平与颈动脉易损斑块的关系,评估ox-LDL对易损性颈动脉斑块的识别能力,为早期识别易损性颈动脉斑块探索新的途径。资料与方法选择经CT和MRI确诊为急性缺血性脑卒中的181例患者,根据颈动脉超声检查将其分为无斑块组48例、稳定斑块组38例、易损斑块组95例。检测血清总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹血糖及血清ox-LDL水平,并采用双功能彩色多普勒超声检测颈动脉内膜中层厚度(IMT)、总斑块面积(TPA)及斑块性质,分析血清ox-LDL与缺血性脑卒中危险因素的相关性。结果斑块组合并高血压、血清ox-LDL明显高于无斑块组(P0.05);易损斑块组血清ox-LDL、TPA明显高于稳定斑块组(P0.01)。血清ox-LDL水平与颈动脉IMT、总胆固醇、LDL-C呈正相关(r1=0.154,P0.05;r2=0.338,P0.05;r3=0.385,P0.05);Logistic回归分析结果显示,血清ox-LDL是急性缺血性脑卒中患者颈动脉易损斑块形成的独立危险因素(OR=1.038,95%CI 1.008~1.069,P0.01)。结论急性缺血性脑卒中患者血清ox-LDL与颈动脉易损斑块的形成独立相关,ox-LDL可以作为临床筛查易损斑块的血清学指标,颈动脉超声联合应用血清学检查可以早期识别可能导致脑缺血事件发生的颈动脉易损斑块。
[Abstract]:Objective to investigate the relationship between serum oxidized low density lipoprotein (ox-LDL) levels and carotid plaque vulnerability in patients with acute ischemic stroke, and to evaluate the ability of ox-LDL to identify vulnerable carotid plaques. To explore a new approach for early identification of vulnerable carotid plaques. Materials and methods 181 patients with acute ischemic stroke diagnosed by CT and MRI were divided into 4 groups according to carotid ultrasound: 48 cases without plaque, 38 cases with stable plaque and 95 cases with vulnerable plaque. Serum total cholesterol, triacylglycerol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, fasting blood glucose and serum ox-LDL were measured. The carotid intima-media thickness (IMT),) was measured by dual-function color Doppler ultrasound. The relationship between serum ox-LDL and risk factors of ischemic stroke was analyzed. Results the serum ox-LDL was significantly higher in the plaque group with hypertension than in the no plaque group (P0.05), and the serum ox-LDL,TPA in the vulnerable plaque group was significantly higher than that in the stable plaque group (P0.01). There was a positive correlation between serum ox-LDL level and total cholesterol of carotid artery IMT, LDL-C (R1: 0.154, P0.05, R2, P0.05, R3, 0.385, P0.05). Logistic regression analysis showed that serum ox-LDL was an independent risk factor for carotid plaque formation in patients with acute ischemic stroke (OR=1.038,95%CI 1.008 / 1.069 / P0.01). Conclusion Serum ox-LDL is independent of carotid plaque formation in patients with acute ischemic stroke. Ox-LDL can be used as a serological index for screening vulnerable plaques. Carotid ultrasound combined with serological examination can identify early carotid plaques that may lead to cerebral ischemia events.
【作者单位】：广州医科大学附属第二医院超声科;广州医科大学附属第二医院神经内科;
【基金】：广东省医学科研基金(A2013277) 广州市科信局民生科技重大专项(2012Y2-00027)
【分类号】：R743.3;R445.1

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