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  本文選題：氧化型低密度脂蛋白 + 頸動脈內(nèi)-中膜厚度��； 參考：《中南大學》2014年碩士論文

【摘要】：目的：探討動脈粥樣硬化性腦梗死(Atherosclerosis Cerebral Infarction,ACI)患者的頸動脈內(nèi)-中膜厚度(Carotid Intima-mediaThickness,CIMT)與氧化型低密度脂蛋白(Oxidized Low-density Lipoprotein,ox-LDL)的關系。 方法：根據(jù)納入標準納入2013.08-2013.11在常德市第一人民醫(yī)院神經(jīng)內(nèi)科住院治療的ACI患者123人作為ACI組,選取同期無腦血管病病史并且與ACI組性別、年齡、生活習慣匹配的健康體檢者43人為對照組。記錄每位研究對象的一般資料、既往病史,并測量血壓、身高、體重,測定ox-LDL、C-反應蛋白(C-creative Protein,CRP)、甘油三酯(Triglyceride,TC)、總膽固醇(total cholesterol,TC)高密度脂蛋白膽固醇(High-density lipoprotein cholesterol,HCL-C)、低密度脂蛋白膽固醇(Low-density lipoprotein cholesterol,LDL-C)、極低密度脂蛋白膽固醇(Very Low-density lipoprotein cholesterol, VLDL-C)、空腹血糖(Fasting Blood Glucose,FBG)、同型半胱氨酸(Homocysteine,Hcy)、尿酸(Uric Acid,UA)尿酸等。依據(jù)CIMT將ACI患者分為CIMT正常組和CIMT增厚組,再根據(jù)斑塊穩(wěn)定性將有頸動脈粥樣斑塊的ACI患者進一步分為穩(wěn)定斑塊組和不穩(wěn)定斑塊組。 結(jié)果：1、ACI組的高血壓、高同型半胱氨酸血癥和高尿酸血癥的發(fā)生率、血漿ox-LDL水平、CIMT增厚率、斑塊及不穩(wěn)定斑塊的檢出率均較對照組顯著升高(P0.01) 2、ACI患者的頸動脈斑塊最常見于頸動脈分叉處(53.2%),穩(wěn)定斑塊和不穩(wěn)定斑塊的位置分布大致相同(P0.05) 3、ACI患者的CIMT與年齡(r=0.183,P0.05)、ox-LDL(r=0.255, P0.01)、FBG(r=0.187,P0.05)及Hcy(r=0.193,P0.05)正相關。 4、經(jīng)多因素logistic回歸分析發(fā)現(xiàn)ACI患者血漿ox-LDL是CIMT增厚(OR=1.013,P0.01)及頸動脈不穩(wěn)定斑塊(OR=1.154,P0.01)的獨立危險因素獨立相關,年齡(OR=1.047,P0.05)、性別(OR=4.227,P0.05)、高同型半胱血癥(OR=3.615,P0.05)與CIMT獨立相關。 結(jié)論：動脈粥樣硬化性腦梗死患者的血漿ox-LDL與CIMT及斑塊穩(wěn)定性密切相關,提示血漿ox-LDL可能可以作為臨床上初篩CIMT增厚和不穩(wěn)定斑塊的指標。
[Abstract]:Objective: to investigate the relationship between carotid intima-media thickness (CIMT) and oxidized low-density lipoprotein (LDL) in patients with Atherosclerosis cerebral infarction (ACI). Methods: 123 ACI patients who were admitted to the Department of Neurology of the first people's Hospital of Changde City as the ACI group according to the inclusion criteria were selected as the ACI group with no history of cerebrovascular disease in the same period and gender and age of the ACI group. There were 43 healthy persons with matched life habits in the control group. We recorded the general data, past medical history, and measured blood pressure, height, weight of each of the subjects. C-creative protein CRP, triglyceride TC, total cholesterol high density lipoprotein cholesterol, low density lipoprotein cholesterol LDL-C, very low density lipoprotein cholesterol (VLDL-C), fasting blood glucose (FBG), homotypic cystein-like cholesterol (LDL-C) were determined by measuring the levels of ox-LDL protein, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, very low density lipoprotein cholesterol, fasting blood glucose, high density lipoprotein cholesterol, low density lipoprotein cholesterol, very low density lipoprotein cholesterol, fasting blood glucose, high density lipoprotein cholesterol, low density lipoprotein cholesterol, very low density lipoprotein cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, very low density lipoprotein cholesterol, fasting blood glucose, high density lipoprotein cholesterol, low density lipoprotein cholesterol, very low density lipoprotein cholesterol (VLDL-C), fasting blood glucose (FBG). Homocysteine (Hcy), uric acid (uric acid) uric acid, etc. ACI patients were divided into CIMT normal group and CIMT thickening group according to CIMT. ACI patients with carotid atherosclerotic plaque were further divided into stable plaque group and unstable plaque group according to plaque stability. Results the incidence of hypertension, hyperhomocysteinemia and hyperuricemia, plasma ox-LDL level and CIMT thickening rate were observed in the ACI group. The detection rate of plaque and unstable plaque was significantly higher than that of control group (P0.01) 2carotid plaque was most common in the bifurcation of carotid artery (53.2%), and the distribution of stable plaque and unstable plaque was approximately the same (P0.05). 3CIMT in patients with ACI was positively correlated with age (r = 0.183, P 0.05), FBG (r = 0.185, P 0.01) and homocysteine (r = 0.193, P 0.05). 4. Plasma ox-LDL was found to be an independent risk factor for CIMT thickening (OR1.013 / P0.01) and carotid artery unstable plaque (OR1.154P0.01) by multivariate logistic regression analysis. Age (ORV 1.047 P 0.05), sex (ORT 4.227 P 0.05), and high homotypic cysteinemia (ORT 3.615 P 0.05) were independently correlated with CIMT. Conclusion: plasma ox-LDL is closely related to CIMT and plaque stability in patients with atherosclerotic cerebral infarction, suggesting that plasma ox-LDL may be used as a marker of CIMT thickening and unstable plaque.
【學位授予單位】：中南大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R743.3

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