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目的探讨伴或不伴颅内大动脉病变的轻型脑卒中患者急性期血清炎性指标和凝血指标的差异,以期能为轻型脑卒中的病因鉴别提供血清学帮助。方法 56例轻型脑卒中患者根据脑血管造影、头颅磁共振及心脏评估分为两组:大血管病变组(14例)和小动脉病变组(42例)。比较两组患者急性期血清高敏C反应蛋白和D二聚体的水平差异。结果两组患者在血管危险因素方面没有显著差异,25%的轻型脑卒中患者存在责任大动脉狭窄或闭塞;大血管病变组的血清hsCRP水平显著高于小血管病变组(P<0.01);大血管病变组的血清D二聚体水平高于小血管病变组,但差异不明显(P=0.085)。大血管严重狭窄患者的血清D二聚体水平显著高于轻-中度狭窄的患者(P<0.05)。结论炎症反应参与的斑块不稳定和微小栓塞可能是大动脉病变导致轻型脑卒中的主要发病机制。
Objective To investigate the difference of serum inflammatory markers and coagulation markers in acute stroke patients with and without intracranial aortic lesion in order to provide serological help for the etiological diagnosis of mild stroke. Methods Fifty-six patients with mild stroke were divided into two groups based on cerebral angiography, cranial magnetic resonance imaging and cardiac evaluation: macrovascular disease group (n = 14) and arteriolar arterial disease group (n = 42). The levels of serum high-sensitivity C-reactive protein and D-dimer in acute phase were compared between the two groups. Results There was no significant difference in vascular risk factors between the two groups. Serum aortic stenosis or occlusion was found in 25% of patients with mild stroke; serum hsCRP was significantly higher in patients with macrovascular complications than in small vessel disease (P <0.01) Serum D dimer levels in the lesion group were higher than those in the small vessel lesion group, but the difference was not significant (P = 0.085). Serum D dimer levels in patients with severe major stenosis were significantly higher than those in patients with mild to moderate stenosis (P <0.05). Conclusions The plaque instability and micro embolism involved in the inflammatory response may be the main pathogenesy of aortic lesions leading to light stroke.