动脉粥样硬化性脑梗死患者CIMT与血浆ox-LDL的相关性研究

发布时间：2018-06-26 03:11

本文选题：氧化型低密度脂蛋白 + 颈动脉内-中膜厚度　；参考：《中南大学》2014年硕士论文

【摘要】：目的：探讨动脉粥样硬化性脑梗死(Atherosclerosis Cerebral Infarction,ACI)患者的颈动脉内-中膜厚度(Carotid Intima-mediaThickness,CIMT)与氧化型低密度脂蛋白(Oxidized Low-density Lipoprotein,ox-LDL)的关系。方法：根据纳入标准纳入2013.08-2013.11在常德市第一人民医院神经内科住院治疗的ACI患者123人作为ACI组,选取同期无脑血管病病史并且与ACI组性别、年龄、生活习惯匹配的健康体检者43人为对照组。记录每位研究对象的一般资料、既往病史,并测量血压、身高、体重,测定ox-LDL、C-反应蛋白(C-creative Protein,CRP)、甘油三酯(Triglyceride,TC)、总胆固醇(total cholesterol,TC)高密度脂蛋白胆固醇(High-density lipoprotein cholesterol,HCL-C)、低密度脂蛋白胆固醇(Low-density lipoprotein cholesterol,LDL-C)、极低密度脂蛋白胆固醇(Very Low-density lipoprotein cholesterol, VLDL-C)、空腹血糖(Fasting Blood Glucose,FBG)、同型半胱氨酸(Homocysteine,Hcy)、尿酸(Uric Acid,UA)尿酸等。依据CIMT将ACI患者分为CIMT正常组和CIMT增厚组,再根据斑块稳定性将有颈动脉粥样斑块的ACI患者进一步分为稳定斑块组和不稳定斑块组。结果：1、ACI组的高血压、高同型半胱氨酸血症和高尿酸血症的发生率、血浆ox-LDL水平、CIMT增厚率、斑块及不稳定斑块的检出率均较对照组显著升高(P0.01) 2、ACI患者的颈动脉斑块最常见于颈动脉分叉处(53.2%),稳定斑块和不稳定斑块的位置分布大致相同(P0.05) 3、ACI患者的CIMT与年龄(r=0.183,P0.05)、ox-LDL(r=0.255, P0.01)、FBG(r=0.187,P0.05)及Hcy(r=0.193,P0.05)正相关。 4、经多因素logistic回归分析发现ACI患者血浆ox-LDL是CIMT增厚(OR=1.013,P0.01)及颈动脉不稳定斑块(OR=1.154,P0.01)的独立危险因素独立相关,年龄(OR=1.047,P0.05)、性别(OR=4.227,P0.05)、高同型半胱血症(OR=3.615,P0.05)与CIMT独立相关。结论：动脉粥样硬化性脑梗死患者的血浆ox-LDL与CIMT及斑块稳定性密切相关,提示血浆ox-LDL可能可以作为临床上初筛CIMT增厚和不稳定斑块的指标。
[Abstract]:Objective: to investigate the relationship between carotid intima-media thickness (CIMT) and oxidized low-density lipoprotein (LDL) in patients with Atherosclerosis cerebral infarction (ACI). Methods: 123 ACI patients who were admitted to the Department of Neurology of the first people's Hospital of Changde City as the ACI group according to the inclusion criteria were selected as the ACI group with no history of cerebrovascular disease in the same period and gender and age of the ACI group. There were 43 healthy persons with matched life habits in the control group. We recorded the general data, past medical history, and measured blood pressure, height, weight of each of the subjects. C-creative protein CRP, triglyceride TC, total cholesterol high density lipoprotein cholesterol, low density lipoprotein cholesterol LDL-C, very low density lipoprotein cholesterol (VLDL-C), fasting blood glucose (FBG), homotypic cystein-like cholesterol (LDL-C) were determined by measuring the levels of ox-LDL protein, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, very low density lipoprotein cholesterol, fasting blood glucose, high density lipoprotein cholesterol, low density lipoprotein cholesterol, very low density lipoprotein cholesterol, fasting blood glucose, high density lipoprotein cholesterol, low density lipoprotein cholesterol, very low density lipoprotein cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, very low density lipoprotein cholesterol, fasting blood glucose, high density lipoprotein cholesterol, low density lipoprotein cholesterol, very low density lipoprotein cholesterol (VLDL-C), fasting blood glucose (FBG). Homocysteine (Hcy), uric acid (uric acid) uric acid, etc. ACI patients were divided into CIMT normal group and CIMT thickening group according to CIMT. ACI patients with carotid atherosclerotic plaque were further divided into stable plaque group and unstable plaque group according to plaque stability. Results the incidence of hypertension, hyperhomocysteinemia and hyperuricemia, plasma ox-LDL level and CIMT thickening rate were observed in the ACI group. The detection rate of plaque and unstable plaque was significantly higher than that of control group (P0.01) 2carotid plaque was most common in the bifurcation of carotid artery (53.2%), and the distribution of stable plaque and unstable plaque was approximately the same (P0.05). 3CIMT in patients with ACI was positively correlated with age (r = 0.183, P 0.05), FBG (r = 0.185, P 0.01) and homocysteine (r = 0.193, P 0.05). 4. Plasma ox-LDL was found to be an independent risk factor for CIMT thickening (OR1.013 / P0.01) and carotid artery unstable plaque (OR1.154P0.01) by multivariate logistic regression analysis. Age (ORV 1.047 P 0.05), sex (ORT 4.227 P 0.05), and high homotypic cysteinemia (ORT 3.615 P 0.05) were independently correlated with CIMT. Conclusion: plasma ox-LDL is closely related to CIMT and plaque stability in patients with atherosclerotic cerebral infarction, suggesting that plasma ox-LDL may be used as a marker of CIMT thickening and unstable plaque.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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