青海西宁地区红细胞分布宽度和脑梗死患者颈动脉粥样硬化斑块稳定性的关系

发布时间：2018-04-13 00:01

本文选题：高原 + 红细胞分布宽度　；参考：《青海大学》2017年硕士论文

【摘要】：目的:青海位于青藏高原,高原地区RDW(红细胞分布宽度)与脑梗死患者颈动脉斑块稳定性的关系,本实验通过观察青海西宁地区红细胞分布宽度与脑梗死患者颈动脉粥样硬化斑块稳定性的关系,为颈动脉粥样硬化斑块患者预防脑梗死提供理论依据。方法:连续入选2015年4月-2016年11月就诊于青海大学附属神经内科,世居在青海西宁地区的首次发病的病程均小于72 h急性脑梗死104例。行颈动脉彩超检查,根据颈动脉彩超检查结果分为颈动脉正常组和颈动脉异常组,颈动脉异常组再行头颈部CTA检查,根据CTA检查结果分为硬斑块组、软斑块组、混合斑块组。收集一般临床资料及脑梗死的危险因素,测定血脂、糖化血红蛋白、低密度胆固醇、高密度胆固醇、甘油三酯、高敏C反应蛋白(hs-CRP)等,并进行组间比较。结果:(1)颈动脉异常组RDW明显高于颈动脉正常组(P0.05);(2)硬斑快组RDW高于颈动脉正常组(P0.05);(3)混合斑块组高于硬斑块组(P0.05);(4)软斑块组高于混合斑块组(P0.05);(5)相关性分析显示,性别、年龄、高血压、糖尿病、冠心病、吸烟、RDW、TG、LDL-C、hs-CRP、尿酸与颈动脉斑块不稳定性呈正相关。(6)应用多元线性逐步回归分析,最终纳入回归方程的指标是高血压、LDL、RDW,调整高血压、LDL影响因素后,RDW仍为颈动脉不稳定斑块的独立危险因素(OR=5.843,95%CI:2.321~14.705,P0.05)。(7)经Spearman等级相关性分析,RDW水平与颈动脉斑块易损程度呈正相关(r=0.727、P0.05),即RDW是颈动脉斑块的独立影响因素,且随着斑块稳定性改变而RDW水平随之增高。结论:1)RDW、LDL、高血压为颈动脉斑块稳定性的独立危险因素。(2)随着RDW值的增大,颈动脉斑块的稳定性逐渐降低,可作为检测易损斑块的新指标。3)RDW和性别、年龄、高血压、糖尿病、冠心病、吸烟、TG、LDL-C、hs-CRP、尿酸一样,为颈动脉斑块稳定性的危险因素。
[Abstract]:Objective: to study the relationship between RDW (erythrocyte distribution width) and carotid plaque stability in patients with cerebral infarction.By observing the relationship between the distribution width of red blood cells and the stability of carotid atherosclerotic plaques in patients with cerebral infarction, this experiment provides a theoretical basis for the prevention of cerebral infarction in patients with carotid atherosclerotic plaques.Methods: 104 cases of acute cerebral infarction were selected from April 2015 to November 2016 in the Department of Neurology affiliated to Qinghai University. The first disease course in Xining area of Qinghai Province was less than 72 hours.According to the results of carotid color Doppler ultrasound, the patients were divided into normal carotid artery group and abnormal carotid artery group, and then head and neck CTA examination in carotid artery abnormal group. According to the results of CTA, they were divided into hard plaque group, soft plaque group and mixed plaque group.General clinical data and risk factors of cerebral infarction were collected, and blood lipids, glycosylated hemoglobin, low density cholesterol, high density cholesterol, triglyceride, Gao Min C-reactive protein hs-CRP were measured and compared among groups.Diabetes mellitus, coronary heart disease, smoking, RDWN LDL-Cnhs-CRP, uric acid and carotid plaque instability were positively correlated with multivariate linear stepwise regression analysis.RDW is an independent factor of carotid plaque.The RDW level increased with the change of plaque stability.Coronary heart disease (CHD), smoking TGG LDL-CRP and uric acid were risk factors for carotid plaque stability.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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