【摘要】：目的探討急性缺血性腦卒中患者血清氧化型低密度脂蛋白(ox-LDL)水平與頸動(dòng)脈易損斑塊的關(guān)系,評(píng)估ox-LDL對(duì)易損性頸動(dòng)脈斑塊的識(shí)別能力,為早期識(shí)別易損性頸動(dòng)脈斑塊探索新的途徑。資料與方法選擇經(jīng)CT和MRI確診為急性缺血性腦卒中的181例患者,根據(jù)頸動(dòng)脈超聲檢查將其分為無斑塊組48例、穩(wěn)定斑塊組38例、易損斑塊組95例。檢測(cè)血清總膽固醇、三酰甘油、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、空腹血糖及血清ox-LDL水平,并采用雙功能彩色多普勒超聲檢測(cè)頸動(dòng)脈內(nèi)膜中層厚度(IMT)、總斑塊面積(TPA)及斑塊性質(zhì),分析血清ox-LDL與缺血性腦卒中危險(xiǎn)因素的相關(guān)性。結(jié)果斑塊組合并高血壓、血清ox-LDL明顯高于無斑塊組(P0.05);易損斑塊組血清ox-LDL、TPA明顯高于穩(wěn)定斑塊組(P0.01)。血清ox-LDL水平與頸動(dòng)脈IMT、總膽固醇、LDL-C呈正相關(guān)(r1=0.154,P0.05;r2=0.338,P0.05;r3=0.385,P0.05);Logistic回歸分析結(jié)果顯示,血清ox-LDL是急性缺血性腦卒中患者頸動(dòng)脈易損斑塊形成的獨(dú)立危險(xiǎn)因素(OR=1.038,95%CI 1.008~1.069,P0.01)。結(jié)論急性缺血性腦卒中患者血清ox-LDL與頸動(dòng)脈易損斑塊的形成獨(dú)立相關(guān),ox-LDL可以作為臨床篩查易損斑塊的血清學(xué)指標(biāo),頸動(dòng)脈超聲聯(lián)合應(yīng)用血清學(xué)檢查可以早期識(shí)別可能導(dǎo)致腦缺血事件發(fā)生的頸動(dòng)脈易損斑塊。
[Abstract]:Objective to investigate the relationship between serum oxidized low density lipoprotein (ox-LDL) levels and carotid plaque vulnerability in patients with acute ischemic stroke, and to evaluate the ability of ox-LDL to identify vulnerable carotid plaques. To explore a new approach for early identification of vulnerable carotid plaques. Materials and methods 181 patients with acute ischemic stroke diagnosed by CT and MRI were divided into 4 groups according to carotid ultrasound: 48 cases without plaque, 38 cases with stable plaque and 95 cases with vulnerable plaque. Serum total cholesterol, triacylglycerol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, fasting blood glucose and serum ox-LDL were measured. The carotid intima-media thickness (IMT),) was measured by dual-function color Doppler ultrasound. The relationship between serum ox-LDL and risk factors of ischemic stroke was analyzed. Results the serum ox-LDL was significantly higher in the plaque group with hypertension than in the no plaque group (P0.05), and the serum ox-LDL,TPA in the vulnerable plaque group was significantly higher than that in the stable plaque group (P0.01). There was a positive correlation between serum ox-LDL level and total cholesterol of carotid artery IMT, LDL-C (R1: 0.154, P0.05, R2, P0.05, R3, 0.385, P0.05). Logistic regression analysis showed that serum ox-LDL was an independent risk factor for carotid plaque formation in patients with acute ischemic stroke (OR=1.038,95%CI 1.008 / 1.069 / P0.01). Conclusion Serum ox-LDL is independent of carotid plaque formation in patients with acute ischemic stroke. Ox-LDL can be used as a serological index for screening vulnerable plaques. Carotid ultrasound combined with serological examination can identify early carotid plaques that may lead to cerebral ischemia events.
【作者單位】： 廣州醫(yī)科大學(xué)附屬第二醫(yī)院超聲科;廣州醫(yī)科大學(xué)附屬第二醫(yī)院神經(jīng)內(nèi)科;
【基金】：廣東省醫(yī)學(xué)科研基金(A2013277) 廣州市科信局民生科技重大專項(xiàng)(2012Y2-00027)
【分類號(hào)】：R743.3;R445.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 ;各類腦血管疾病診斷要點(diǎn)[J];中華神經(jīng)科雜志;1996年06期

【共引文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉劍波,史曉冬;香丹注射液對(duì)腦梗死患者血液流變學(xué)的干預(yù)作用[J];安徽中醫(yī)臨床雜志;2003年04期

2 黃俊臣,周紀(jì)平,李彥春;核桃承氣湯對(duì)腦梗死急性期輔助治療作用的觀察[J];安徽中醫(yī)臨床雜志;2003年04期

3 龐家善,李樹標(biāo),陳艷艷;自擬化痰祛瘀方治療急性腦梗死療效觀察[J];中醫(yī)藥臨床雜志;2004年01期

4 潘啟明,張松林,蘭小平;自擬偏癱方配合早期康復(fù)治療腦梗死偏癱56例臨床觀察[J];中醫(yī)藥臨床雜志;2004年02期

5 華卡;復(fù)方丹參注射液治療急性腦梗死臨床藥效分析[J];中醫(yī)藥臨床雜志;2004年04期

6 郭漢強(qiáng);醒腦凈合息風(fēng)通絡(luò)化痰湯對(duì)急性腦出血的治療作用[J];中醫(yī)藥臨床雜志;2004年05期

7 張波,鄭軍,鮑遠(yuǎn)程,蔡永亮,陳懷珍,王艷昕,王曉e，

本文編號(hào)：2428673