本文關(guān)鍵詞： 腦梗死 C反應(yīng)蛋白質(zhì) 脂蛋白類 LDL　出處：《河北醫(yī)科大學(xué)學(xué)報(bào)》2017年05期 　論文類型：期刊論文

【摘要】：目的檢測(cè)不同TOAST分型急性腦梗死患者血清高敏C反應(yīng)蛋白(high sensitive-C reactive protein,hs-CRP)和低密度脂蛋白(low density lipoprotein,LDL)水平,探討hs-CRP和LDL在不同類型腦梗死急性期的作用及臨床意義。方法選取腦梗死患者374例為病例組,健康志愿者60例為正常對(duì)照組。病例組患者按照TOAST分型分為大動(dòng)脈粥樣硬化組(large-artery atherosclerosis,LAA)158例、小動(dòng)脈閉塞組(small-artery occlusion,SAO)171例和心源性栓塞組(cardioembolism,CE)45例。所有受試者于次日清晨空腹抽取肘靜脈血3mL,測(cè)定血清hs-CRP和LDL水平。結(jié)果 LAA、SAO、CE組美國(guó)國(guó)立衛(wèi)生研究院卒中量表(National Institute of Health stroke scale,NIHSS)評(píng)分、收縮壓、舒張壓明顯高于對(duì)照組,LAA組和CE組NIHSS評(píng)分高于SAO組,LAA、SAO組收縮壓高于CE組。LAA、SAO組吸煙、糖尿病發(fā)生率高于對(duì)照組和CE組,SAO組飲酒發(fā)生率高于對(duì)照組,LAA、SAO、CE組高血壓、高脂血癥、心臟病發(fā)生率高于對(duì)照組,CE組心臟病發(fā)生率高于LAA組和SAO組。LAA、SAO、CE組血清hs-CRP水平高于對(duì)照組,CE組血清hs-CRP水平高于LAA、SAO組,LAA組血清hsCRP水平高于SAO組。LAA、SAO組血清LDL水平高于對(duì)照組(P0.05)。急性腦梗死患者血清hs-CRP水平與LDL、NIHSS評(píng)分呈正相關(guān)(rs=0.164、0.183,P0.05)。二分類Logistic回歸分析結(jié)果顯示,收縮壓、hs-CRP是心源性腦栓死的危險(xiǎn)因素。結(jié)論在TOAST亞型中,血清hs-CRP可作為CE的危險(xiǎn)因素,成為腦梗死發(fā)病早期判定病因?qū)W分類的指標(biāo)。LDL有望成為L(zhǎng)AA的特異性生化指標(biāo),對(duì)早期預(yù)測(cè)LAA有重要臨床價(jià)值。
[Abstract]:Objective to detect the serum Gao Min C-reactive protein high sensitive-C reactive protein in patients with acute cerebral infarction according to different TOAST classification. Hs-CRP) and low density lipoprotein (LDL). To explore the role and clinical significance of hs-CRP and LDL in acute phase of different types of cerebral infarction methods 374 patients with cerebral infarction were selected as the case group. According to TOAST classification, 60 healthy volunteers were divided into large artery atherosclerosis group and large artery atherosclerosis group. LAA)158, small artery occlusion and cardioembolism were observed in 171patients with small artery occlusion and cardioembolism. Cases of CE)45. All subjects took 3mL of blood from cubital vein on an empty stomach the next morning to determine the levels of serum hs-CRP and LDL. In CE group, the National Institute of Health stroke scale (NIHSS) was used. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly higher than those in control group (LAA group) and CE group (P < 0.05). The incidence of diabetes mellitus was higher than that of control group and CE group. The incidence of alcohol consumption in SAO group was higher than that in control group. The incidence of hypertension, hyperlipidemia and heart disease in SAO group was higher than that in control group. The incidence of heart disease in CE group was higher than that in LAA group and SAO group. The serum hs-CRP level in CE group was higher than that in control group. The hs-CRP level in CE group was higher than that in LAA group. The level of serum hsCRP in SAO group was higher than that in SAO group. The serum LDL level in SAO group was higher than that in control group (P 0.05). There was a positive correlation between serum hs-CRP level and NIHSS score in patients with acute cerebral infarction (ACI). The results of two classification Logistic regression analysis showed that systolic blood pressure (SBP) hs-CRP was the risk factor of cardiogenic brain thrombus death. Conclusion it is in TOAST subtype. Serum hs-CRP can be used as a risk factor of CE, and it is expected to be a specific biochemical index of LAA in the early stage of cerebral infarction. It has important clinical value for early prediction of LAA.
【作者單位】： 河北醫(yī)科大學(xué)第二醫(yī)院神經(jīng)內(nèi)科;河北省定州市第二醫(yī)院神經(jīng)內(nèi)科;
【分類號(hào)】：R743.33
【正文快照】： 腦梗死通常是指腦部的血液供應(yīng)障礙或腦組織局部缺血缺氧而造成的局部腦組織壞死,又稱缺血性腦卒中,其主要原因是腦血管出現(xiàn)了動(dòng)脈粥樣硬化和血栓形成,使腦部血管逐漸狹窄或者完全閉塞,最終導(dǎo)致血液供應(yīng)障礙。對(duì)于缺血性卒中不同病因分型要采取針對(duì)性的治療方法�，F(xiàn)已證實(shí)急性

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