纤维蛋白原、C反应蛋白及同型半胱氨酸与大动脉粥样硬化型卒中患者颈动脉易损性斑块的相关性分析

发布时间：2018-06-26 17:56

本文选题：卒中 + 颈动脉　；参考：《解放军医学杂志》2017年01期

【摘要】：目的探讨血清纤维蛋白原(FIB)、C反应蛋白(CRP)及同型半胱氨酸(Hcy)水平与大动脉粥样硬化(LAA)型卒中患者颈动脉易损性斑块的关系。方法收集2014年3月-2015年2月兰州大学第二医院神经内科连续收治的急性缺血性卒中(AIS)住院患者,依据TOAST分型选择其中的LAA型前循环区域卒中患者273例,根据颈部血管超声结果分为无斑块组(n=84)、稳定斑块组(n=42)、易损斑块组(n=147),另收集同期住院的非脑卒中患者中无颈动脉病变的182例作为对照组,比较4组患者19项人口学和血液检测指标的差异。采用Logistic回归对LAA型卒中患者颈动脉易损性斑块的危险因素进行筛选,采用Spearman秩相关对患者颈动脉斑块易损性与各指标的相关性进行分析。结果FIB、CRP及Hcy水平在四组间的比较差异有统计学意义(P0.05);多因素Logistic回归分析显示,FIB(OR=1.408,95%CI1.028-1.927,P=0.033)是L AA型卒中患者颈动脉易损性斑块的独立危险因素;Spearman相关分析显示,FIB(r=0.292,P=0.000)、Hcy(r=0.172,P=0.000)与L AA型卒中患者颈动脉斑块易损性呈正相关。结论血清FIB、Hcy水平可能是预测LAA型卒中患者颈动脉斑块易损性的生物学指标;血清CRP水平与LAA型卒中患者颈动脉斑块易损性无明显关联。
[Abstract]:Objective to investigate the relationship between serum fibrinogen (FIB) C reactive protein (CRP) and homocysteine (Hcy) and carotid plaque in patients with large artery atherosclerosis (LAA). Methods from March 2014 to February 2015, 273 patients with acute ischemic stroke (AIS) who were admitted to Department of Neurology, second Hospital of Lanzhou University from March 2014 to February 2015 were selected according to the TOAST classification. According to the results of cervical vascular ultrasound, they were divided into four groups: no plaque group (n = 84), stable plaque group (n = 42) and vulnerable plaque group (n = 147). 182 patients without carotid artery disease were collected as control group. 19 items of demography and blood test were compared among 4 groups. Logistic regression was used to screen the risk factors of carotid artery vulnerability plaque in patients with LAA type stroke. Spearman rank correlation was used to analyze the correlation between carotid plaque vulnerability and various indexes. Results the levels of FIBP and Hcy were significantly different among the four groups (P0.05), and the multivariate logistic regression analysis showed that FIB (OR1.408 ~ 95CI 1.028-1.927 P0.033) was an independent risk factor for carotid artery vulnerable plaque in patients with LAA type stroke. Spearman correlation analysis showed that FIB (r = 0.292P = 0.000) and LAA type stroke were associated with FIB (r = 0.172P = 0.000) and LAA type stroke by Spearman correlation analysis. There was a positive correlation between carotid plaque vulnerability and carotid plaque vulnerability. Conclusion Serum FIBG Hcy level may be a biological index for predicting the vulnerability of carotid plaque in patients with LAA type stroke, and there is no significant correlation between serum CRP level and carotid plaque vulnerability in patients with LAA type stroke.
【作者单位】：兰州大学第二医院神经内科;
【基金】：兰州市科技计划项目(2011-1-134)~~
【分类号】：R743.3

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