不同TOAST分型急性脑梗死患者血清hs-CRP和LDL水平变化及临床意义

发布时间：2018-02-02 15:55

本文关键词： 脑梗死 C反应蛋白质脂蛋白类 LDL　出处：《河北医科大学学报》2017年05期 　论文类型：期刊论文

【摘要】：目的检测不同TOAST分型急性脑梗死患者血清高敏C反应蛋白(high sensitive-C reactive protein,hs-CRP)和低密度脂蛋白(low density lipoprotein,LDL)水平,探讨hs-CRP和LDL在不同类型脑梗死急性期的作用及临床意义。方法选取脑梗死患者374例为病例组,健康志愿者60例为正常对照组。病例组患者按照TOAST分型分为大动脉粥样硬化组(large-artery atherosclerosis,LAA)158例、小动脉闭塞组(small-artery occlusion,SAO)171例和心源性栓塞组(cardioembolism,CE)45例。所有受试者于次日清晨空腹抽取肘静脉血3mL,测定血清hs-CRP和LDL水平。结果 LAA、SAO、CE组美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、收缩压、舒张压明显高于对照组,LAA组和CE组NIHSS评分高于SAO组,LAA、SAO组收缩压高于CE组。LAA、SAO组吸烟、糖尿病发生率高于对照组和CE组,SAO组饮酒发生率高于对照组,LAA、SAO、CE组高血压、高脂血症、心脏病发生率高于对照组,CE组心脏病发生率高于LAA组和SAO组。LAA、SAO、CE组血清hs-CRP水平高于对照组,CE组血清hs-CRP水平高于LAA、SAO组,LAA组血清hsCRP水平高于SAO组。LAA、SAO组血清LDL水平高于对照组(P0.05)。急性脑梗死患者血清hs-CRP水平与LDL、NIHSS评分呈正相关(rs=0.164、0.183,P0.05)。二分类Logistic回归分析结果显示,收缩压、hs-CRP是心源性脑栓死的危险因素。结论在TOAST亚型中,血清hs-CRP可作为CE的危险因素,成为脑梗死发病早期判定病因学分类的指标。LDL有望成为LAA的特异性生化指标,对早期预测LAA有重要临床价值。
[Abstract]:Objective to detect the serum Gao Min C-reactive protein high sensitive-C reactive protein in patients with acute cerebral infarction according to different TOAST classification. Hs-CRP) and low density lipoprotein (LDL). To explore the role and clinical significance of hs-CRP and LDL in acute phase of different types of cerebral infarction methods 374 patients with cerebral infarction were selected as the case group. According to TOAST classification, 60 healthy volunteers were divided into large artery atherosclerosis group and large artery atherosclerosis group. LAA)158, small artery occlusion and cardioembolism were observed in 171patients with small artery occlusion and cardioembolism. Cases of CE)45. All subjects took 3mL of blood from cubital vein on an empty stomach the next morning to determine the levels of serum hs-CRP and LDL. In CE group, the National Institute of Health stroke scale (NIHSS) was used. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly higher than those in control group (LAA group) and CE group (P < 0.05). The incidence of diabetes mellitus was higher than that of control group and CE group. The incidence of alcohol consumption in SAO group was higher than that in control group. The incidence of hypertension, hyperlipidemia and heart disease in SAO group was higher than that in control group. The incidence of heart disease in CE group was higher than that in LAA group and SAO group. The serum hs-CRP level in CE group was higher than that in control group. The hs-CRP level in CE group was higher than that in LAA group. The level of serum hsCRP in SAO group was higher than that in SAO group. The serum LDL level in SAO group was higher than that in control group (P 0.05). There was a positive correlation between serum hs-CRP level and NIHSS score in patients with acute cerebral infarction (ACI). The results of two classification Logistic regression analysis showed that systolic blood pressure (SBP) hs-CRP was the risk factor of cardiogenic brain thrombus death. Conclusion it is in TOAST subtype. Serum hs-CRP can be used as a risk factor of CE, and it is expected to be a specific biochemical index of LAA in the early stage of cerebral infarction. It has important clinical value for early prediction of LAA.
【作者单位】：河北医科大学第二医院神经内科;河北省定州市第二医院神经内科;
【分类号】：R743.33
【正文快照】： 脑梗死通常是指脑部的血液供应障碍或脑组织局部缺血缺氧而造成的局部脑组织坏死,又称缺血性脑卒中,其主要原因是脑血管出现了动脉粥样硬化和血栓形成,使脑部血管逐渐狭窄或者完全闭塞,最终导致血液供应障碍。对于缺血性卒中不同病因分型要采取针对性的治疗方法。现已证实急性

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