摘要
目的：研究急性脑梗死后血管内皮功能的变化情况,并分析其与脑梗死类型及颈动脉斑块性质的相关性。方法：选择2012年1月-2014年12月在湖北医药学院附属太和医院接受治疗的脑梗死病患147例作为研究对象。根据病史及MRI诊断结果分为急性脑梗死组105例和非急性组42例,对比两组间的内皮细胞功能。再对急性组进行梗死类型以及颈动脉斑块性质分组,探究梗死类型与斑块性质与RHI的相关性。结果：急性组的Fbg、HbA1c、LDL、VEGF、hs-CRP和big ET-1水平均显著高于非急性组,RHI水平低于非急性组（均P〈0.05）。并且不同急性脑梗死TOAST分型中CE、SAA、SUE、LAA测得RHI水平逐渐上升,hs-CRP和big ET-1水平逐渐下降（均P〈0.05）。在对比不同斑块性质的病患发现无斑组、硬斑组、软斑组、混合斑组RHI水平逐渐降低、VEGF水平逐渐升高（均P〈0.05）。RHI与hs-CRP、big ET-1以及斑块性质均呈现负相关（r=-0.3,P〈0.05;r=-0.8,P〈0.05;r=-1.2,P〈0.05）。结论：急性脑梗死病患出现高纤维蛋白原血症等疾病的可能性增加,因此临床上可以借助对Fbg等水平的监测来指导急性脑梗死的临床治疗。急性脑梗死后血管内皮细胞功能出现障碍,并且与梗死类型、颈动脉斑块的性质存在一定的相关性。
Objective：To study the changes of vascular endothelial function in patients with acute cerebral infarction,and to analyze its correlation with the types of cerebral infarction and carotid plaque.Method：A total of 147 patients with cerebral infarction that were treated in Hubei Taihe Hospital Affiliated to Hubei College of Medicine and Pharmacy were selected.According to the diagnostic results of MRI,these patients were divided into acute cerebral infarction group（n=105cases）,and non acute group（n=42cases）.Endothelial cell function were compared between the two groups.Then the acute infarction group was divided into two groups according to the type of infarction and carotid plaque in order to explore the correlation among them.Results：Fbg,HbA1 c,LDL,VEGF,hs-CRP and big ET-1level of the acute group were significantly higher than those in non acute group,but RHI level was lower than that of non acute group.In CE,SAA,SUE,LAA of the TOAST subgroup,RHI level was gradually increased but hs-CRP and big ET-1level gradually decreased（P both〈0.05）.As for patientswith different types of plaque,the level of RHI gradually decreased in patients without plaque,with hard plaque group,soft plaque group,and with mixed plaque group,but VEGF gradually increased in the above subgroup of patients.RHI and hsCRP,ET-1and type of plaque were negatively correlated（r=-0.3,P〈0.05;r=-0.8,P〈0.05;r=-1.2,P 〈0.05）.Conclusion：Among patients with acute cerebral infarction,incidence of hyperfibrinogenemia disease may increase,monitoring of Fbg levels can be used to guide the treatment of acute cerebral infarction.After occurrence of acute cerebral infarction,dysfunction of vascular endothelial cell may happen which is correlated with the type of infarction,and nature of carotid artery plaque.
出处
《海南医学院学报》
CAS
2015年第12期1713-1715,1719,共4页
Journal of Hainan Medical University
基金
湖北省科技厅资助项目(2011DGA13012)~~
关键词
急性脑梗死
血管内皮功能
TOAST分型
颈动脉斑块
Acute cerebral infarction
Vascular endothelial function
TOAST type
Carotid plaque
Correlation
