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目的探讨缺血性脑卒中伴颈动脉易损性斑块的临床特点以及与炎症因子的关系。方法连续收集缺血性脑卒中患者398例,进行CT血管成像联合颈动脉超声检查,分析斑块性质、形态,根据患者发生颈动脉斑块的性质将其分为易损性斑块组152例,非易损性斑块组246例,对二组采集研究对象的基线资料和疾病史进行单因素分析和多因素Logistic回归分析。结果二组比较,易损性斑块组患者年龄、血同型半胱氨酸、高敏C反应蛋白、白细胞、中性粒细胞、嗜酸性粒细胞、纤维蛋白原水平偏高、吸烟所占比例明显升高,HDL-C水平明显降低,差异有统计学意义。高敏C反应蛋白、白细胞、中性粒细胞、嗜酸性粒细胞、纤维蛋白原与缺血性脑卒中患者颈动脉易损性斑块发生相关。高敏C反应蛋白对易损斑块的敏感性,特异性最高。结论炎症因子水平升高是缺血性脑卒中伴颈动脉易损性斑块发生的重要危险因素。
Objective To investigate the clinical features of ischemic stroke with carotid vulnerable plaque and its relationship with inflammatory factors. Methods A total of 398 patients with ischemic stroke were enrolled in this study. CT angiography and carotid ultrasonography were performed to analyze the nature and morphology of plaque. According to the characteristics of carotid plaques, 152 patients with vulnerable plaque were divided into three groups: , 246 cases of non-vulnerable plaque group. One-factor analysis and multivariate logistic regression analysis were performed on the baseline data and disease history of the two groups. Results In the two groups, age, blood homocysteine, high-sensitivity C-reactive protein, leukocyte, neutrophil, eosinophil and fibrinogen in the vulnerable plaque group were higher than those in the control group Increased, HDL-C levels were significantly lower, the difference was statistically significant. High-sensitivity C-reactive protein, leukocyte, neutrophil, eosinophil and fibrinogen were associated with carotid vulnerable plaque in patients with ischemic stroke. Sensitivity of high-sensitivity C-reactive protein to vulnerable plaque, the highest specificity. Conclusion The increase of inflammatory cytokines is an important risk factor of carotid artery vulnerable plaques in ischemic stroke.