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目的探讨短暂性脑缺血发作(transient ischemic attack,TIA)、单/多发腔隙性脑梗死患者颈动脉及下肢动脉粥样硬化情况,明确血纤维蛋白原水平对颈动脉及下肢动脉粥样硬化的影响。方法对178例短暂性脑缺血发作、单/多发腔隙性脑梗死患者进行颈动脉及下肢动脉彩色多普勒超声检查,记录颈动脉及下肢动脉粥样硬化斑块的部位、大小、数目、回声、动脉分叉处内膜中层厚度(inti ma-media thickness,I MT)及血管内径,并测量血压及纤维蛋白原测定。结果颈动脉粥样硬化斑块位于颈总动脉分叉处最多(占58.3%)。I MT≥1.2mm组血纤维蛋白原水平显著高于I MT<1.2mm组(P<0.05)。下肢动脉粥样硬化位于股动脉最多(占49.6%),I MT≥1.2mm组血纤维蛋白原水平显著高于I MT<1.2mm组(P<0.05)。高水平纤维蛋白原组(≥3.0g/L)易损斑块数量明显增多(P≤0.05)。颈动脉I MT与患者收缩压、舒张压以及纤维蛋白原水平呈正相关(r=4.89、5.37、6.47,P均<0.05),下肢动脉I MT与血糖及纤维蛋白原水平呈正相关(r=4.83、5.38、6.68,P均<0.05)。结论血纤维蛋白原水平与短暂性脑缺血发作、单/多发腔隙性脑梗死患者颈动脉及下肢动脉粥样硬化程度呈正相关。
Objective To investigate the changes of carotid and lower extremity atherosclerosis in patients with transient ischemic attack (TIA) and single / multiple lacunar infarction. To determine the effect of fibrinogen on carotid and lower extremity atherosclerosis Impact. Methods 178 cases of transient ischemic attack, single / multiple lacunar infarction patients with carotid artery and lower extremity artery color Doppler ultrasound recording of carotid and lower extremity atherosclerotic plaque site, size, number , Echo, arterial bifurcation intima-media thickness (I MT) and vascular diameter, and blood pressure and fibrinogen were measured. Results Carotid atherosclerotic plaque was located at the bifurcation of the common carotid artery (58.3%). The level of fibrinogen in I MT≥1.2mm group was significantly higher than that in I MT <1.2mm group (P <0.05). Lower extremity atherosclerosis in the femoral artery (49.6%), I MT ≥ 1.2mm fibrinogen level was significantly higher than I MT <1.2mm group (P <0.05). High-grade fibrinogen group (≥ 3.0g / L) significantly increased the number of vulnerable plaques (P≤0.05). The I MT of carotid arteries was positively correlated with systolic blood pressure, diastolic blood pressure and fibrinogen level (r = 4.89,5.37,6.47, P <0.05). I MT of lower extremity arteries was positively correlated with blood glucose and fibrinogen (r = 4.83 , 5.38,6.68, P <0.05). Conclusion The level of fibrinogen is positively correlated with the degree of atherosclerosis in carotid and lower extremities in patients with transient ischemic attack and single / multiple lacunar infarction.