老年无症状性脑梗死患者颈动脉粥样硬化及其血清Hcy、hs-CRP水平的改变

来源 :中华全科医学 | 被引量 : 0次 | 上传用户:qianchen912009
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目的探讨老年无症状性脑梗死患者血清超敏C反应蛋白(hs-CRP)及同型半胱氨酸(Hcy)与颈动脉粥样硬化的关系。方法收集2009年1月—2013年5月诸暨市人民医院神经内科收治的老年脑梗死患者120例,其中无症状性脑梗死患者62例(ACI组),有症状性脑梗死患者58例(CI组),另选择同期体检健康者50例为对照组。所有患者均行颈动脉彩色多普勒超声检查,并检测血清hs-CRP和Hcy水平。结果对照组、ACI组、CI组,血清hs-CRP、Hcy水平、IMT及粥样斑块发生率呈逐渐升高趋势,3组之间差异均有统计学意义(P<0.05)。ACI组和CI组血清hs-CRP、Hcy水平、IMT及粥样斑块发生率均明显高于对照组(P<0.05),CI组血清hs-CRP、Hcy水平、IMT及粥样斑块发生率均明显高于ACI组(P<0.05)。3组不同性质颈动脉斑块发生率比较,ACI组和CI组不稳定斑块发生率高于对照组(P<0.05)。老年ACI患者无斑块、稳定斑块、不稳定斑块,血清hs-CRP、Hcy水平呈逐渐升高趋势,3组之间差异均有统计学意义(P<0.05)。不稳定性斑块组和稳定性斑块组血清hs-CRP、Hcy水平均明显高于无斑块组(P<0.05),不稳定性斑块组血清hs-CRP、Hcy水平均明显高于稳定性斑块组(P<0.05)。结论血清hs-CRP、Hcy水平和颈动脉粥样硬化的联合检测可为老年ACI患者的早期诊断及进展预测提供重要的临床参考依据。 Objective To investigate the relationship between serum hs-CRP, homocysteine ​​(Hcy) and carotid atherosclerosis in elderly patients with asymptomatic cerebral infarction. Methods A total of 120 elderly patients with cerebral infarction who were admitted to Zhuji People’s Hospital from January 2009 to May 2013 were enrolled. Among them, 62 patients (ACI group) with asymptomatic cerebral infarction, 58 patients with symptomatic cerebral infarction (CI Group), and the other 50 healthy people who chose to be in the same period as the control group. All patients underwent carotid color Doppler ultrasound examination and serum hs-CRP and Hcy levels. Results The levels of hs-CRP, Hcy, IMT and atherosclerotic plaques in control group, ACI group and CI group increased gradually. The differences among the three groups were statistically significant (P <0.05). The levels of serum hs-CRP, Hcy, IMT and atheroma in ACI group and CI group were significantly higher than those in control group (P <0.05). The levels of hs-CRP, Hcy, IMT and atheroma in CI group The rates were significantly higher in ACI group (P <0.05). The incidence of carotid plaques in three groups was higher than that in the control group (P <0.05). There were no plaques, stable plaques and unstable plaques in the elderly patients with ACI. The levels of hs-CRP and Hcy in the elderly patients tended to increase gradually. The differences among the three groups were statistically significant (P <0.05). The levels of serum hs-CRP and Hcy in the unstable plaque group and the stable plaque group were significantly higher than those in the non-plaque group (P <0.05). The serum hs-CRP and Hcy levels in the unstable plaque group were significantly higher than those in the non-plaque group Stability plaque group (P <0.05). Conclusion The combined detection of serum hs-CRP, Hcy levels and carotid atherosclerosis may provide an important clinical reference for the early diagnosis and prognosis of elderly patients with ACI.
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