颈动脉稳定与不稳定斑块急性脑卒中患者血浆UA、Lp-PLA2、D-D、Hcy及Fbg的变化观察
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摘要
目的:观察颈动脉稳定与不稳定斑块急性脑卒中患者血浆尿酸(UA)、脂蛋白相关磷脂酶A2(Lp-PLA2)、D-二聚体(D-D)、同型半胱氨酸(Hcy)及血纤蛋白原(Fbg)的变化情况。方法:选取2017年7月-2018年4月本院收治的36例颈动脉不稳定斑块急性脑卒中患者为观察组,同时期的36例颈动脉稳定斑块急性脑卒中患者为对照组。检测并比较两组UA、Lp-PLA2、D-D、Hcy及Fbg表达水平,两组中不同中国卒中量表评估结果及斑块指数者的表达水平。结果:观察组血浆UA、Lp-PLA2、D-D、Hcy及Fbg表达水平均显著高于对照组(P<0.05),且观察组中不同中国卒中量表评估结果及斑块指数者血浆UA、Lp-PLA2、D-D、Hcy及Fbg表达水平均高于对照组中相同评估结果及斑块指数者,比较差异均有统计学意义(P<0.05)。结论:颈动脉不稳定斑块急性脑卒中患者血浆UA、Lp-PLA2、D-D、Hcy及Fbg表达水平均高于颈动脉稳定斑块者,且不同中国卒中量表评估结果与斑块指数患者的差异明显,因此临床监测价值较高。
Objective:To observe the change situation of plasma uric acid(UA),lipoprotein-associated phospholipase A2(Lp-PLA2),D-dimer(D-D),homocysteine(Hcy)and fibrinogen(Fbg)in the patients with carotid artery stable and unstable plaque of acute stroke.Method:A total of 36 patients with carotid artery unstable plaque of acute stroke in our hospital from July 2017 to April 2018 were selected as observation group,36 patients with carotid artery stable plaque of acute stroke at the same time were selected as control group.The expression levels of plasma UA,Lp-PLA2,D-D,Hcy and Fbg of two groups were detected and compared,and the expression levels of two groups with different Chinese stroke scale evaluation results and plaque index were compared.Result:The expression levels of plasma UA,Lp-PLA2,D-D,Hcy and Fbg of observation groupwere significantly higher than those of control group,the differences were statistically significant(P<0.05),and the expression levels of plasma UA,Lp-PLA2,D-D,Hcy and Fbg in observation group with different Chinese stroke scale evaluation results and plaque index were higher than those of control group with same chinese stroke scale evaluation results and plaque index,the differences were statistically significant(P<0.05). Conclusion:The plasma UA,Lp-PLA2,D-D,Hcy and Fbg in the patients with carotid artery unstable plaque of acute stroke are significantly higher than those of patients with carotid artery stable plaque of acute stroke,and the differences of patients with different Chinese stroke scale evaluation results and plaque index are obvious,so its clinical monitoring value is higher.
Objective:To observe the change situation of plasma uric acid(UA),lipoprotein-associated phospholipase A2(Lp-PLA2),D-dimer(D-D),homocysteine(Hcy)and fibrinogen(Fbg)in the patients with carotid artery stable and unstable plaque of acute stroke.Method:A total of 36 patients with carotid artery unstable plaque of acute stroke in our hospital from July 2017 to April 2018 were selected as observation group,36 patients with carotid artery stable plaque of acute stroke at the same time were selected as control group.The expression levels of plasma UA,Lp-PLA2,D-D,Hcy and Fbg of two groups were detected and compared,and the expression levels of two groups with different Chinese stroke scale evaluation results and plaque index were compared.Result:The expression levels of plasma UA,Lp-PLA2,D-D,Hcy and Fbg of observation groupwere significantly higher than those of control group,the differences were statistically significant(P<0.05),and the expression levels of plasma UA,Lp-PLA2,D-D,Hcy and Fbg in observation group with different Chinese stroke scale evaluation results and plaque index were higher than those of control group with same chinese stroke scale evaluation results and plaque index,the differences were statistically significant(P<0.05). Conclusion:The plasma UA,Lp-PLA2,D-D,Hcy and Fbg in the patients with carotid artery unstable plaque of acute stroke are significantly higher than those of patients with carotid artery stable plaque of acute stroke,and the differences of patients with different Chinese stroke scale evaluation results and plaque index are obvious,so its clinical monitoring value is higher.
引文
[1]刘晓娟.急性脑梗死患者血浆脂蛋白相关磷脂酶水平与颈动脉斑块性质的相关性研究[J].中国药物与临床,2018,18(2):258-260.
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[3]张宝珍.缺血性脑卒中患者血浆中同型半胱氨酸和颈动脉斑块之间的相关性分析[J].中国医学创新,2016,13(12):125-127.
[4]晏晶晶,褚俊,黄文胜,等.原发性高血压患者颈动脉斑块与血压及血浆同型半胱氨酸的相关性[J].中国老年学杂志,2016,36(11):2656-2658.
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[6]张云华,李杰.颈动脉斑块内新生血管显影程度及血浆Lp-PLA2水平对急性脑梗死的临床诊断价值[J].山东大学学报(医学版),2017,55(3):112-116.
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[9]黎舒,柯振符,宁学洪.急性进展性脑梗死患者血浆纤维蛋白原及D-二聚体含量的测定及临床意义[J].医学检验与临床,2014,25(3):79,86.
[10] Boulos N M,Gardin J M,Malik S,et al.Carotid Plaque Characterization,Stenosis,and Intima-Media Thickness According to Age and Gender in a Large Registry Cohort[J].Am J Cardiol,2016,117(7):1185-1191.
[11] Piotr M,Wieslawa T,Lukasz T,et al.Multimarker Approach in Discriminating Patients with Symptomatic and Asymptomatic Atherosclerotic Carotid Artery Stenosis[J].J Clin Neurol,2013,9(3):165-175.
[12]张冰,解学军.幽门螺旋杆菌与颈动脉粥样硬化斑块和血浆脂蛋白相关磷脂酶A2水平的关系[J].赤峰学院学报(自然科学版),2015,31(10):190-192.
[13]费玲,张军,王长厚,等.冠状动脉斑块显像特征与妊娠相关血浆蛋白A水平的关系[J].中华老年心脑血管病杂志,2014,16(7):720-722.
[14]徐东强,刘硕,于成勇,等.血浆脂蛋白磷脂酶A2、同型半胱氨酸与缺血性脑卒中的研究进展[J].中国基层医药,2015,22(14):2218-2221.
[15]杨永海,顾永文,姚雪峰,等.通心络对单纯颈动脉斑块患者血浆超敏C反应蛋白和脂蛋白相关磷脂酶A2的影响[J].中国继续医学教育,2015,7(21):203-204.
[16] Ishiguro T,Yoneyama T,Ishikawa T,et al.Perioperative and Long-term Outcomes of Carotid Endarterectomy for Japanese Asymptomatic Cervical Carotid Artery Stenosis:A Single Institution Study[J].Neurol Med Chir(Tokyo),2015,55(11):830-837.
[17]艾民,颜昌福,夏福纯,等.颈动脉斑块积分、血浆同型半胱氨酸与冠状动脉病变程度的相关性[J].四川医学,2017,38(8):866-868.
[18]邓宇鲲,闫冰,陈涛,等.血浆同型半胱氨酸水平与颈动脉斑块相关性的研究[J].中国循环杂志,2014,29(5):363-366.
[19]顾汉沛,葛剑青,王光胜.血浆Lp-PLA2、HCY、尿酸与血脂对稳定大动脉粥样硬化性脑梗死病人颈动脉斑块的临床意义[J].中西医结合心脑血管病杂志,2017,15(5):613-616.
[20]马鑫,张晖.急性脑梗死患者血清纤维蛋白原血浆D-二聚体与颈动脉粥样硬化斑块的相关性研究[J].中国实用神经疾病杂志,2016,19(8):39-41.
[21]吕桂贤.急性脑梗死患者颈动脉粥样斑块稳定性与血浆脂联素、Lp-PLA2水平的关系[J].心血管康复医学杂志,2015,24(6):597-599.
[2]李娜,赵景茹,杨蕊,等.急性缺血性脑卒中患者血浆Lp-PLA2的表达及与斑块稳定性及神经功能缺损的关系[J].现代生物医学进展,2015,15(28):5506-5508,5534.
[3]张宝珍.缺血性脑卒中患者血浆中同型半胱氨酸和颈动脉斑块之间的相关性分析[J].中国医学创新,2016,13(12):125-127.
[4]晏晶晶,褚俊,黄文胜,等.原发性高血压患者颈动脉斑块与血压及血浆同型半胱氨酸的相关性[J].中国老年学杂志,2016,36(11):2656-2658.
[5]中华医学会神经病学分会.中国急性期缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[6]张云华,李杰.颈动脉斑块内新生血管显影程度及血浆Lp-PLA2水平对急性脑梗死的临床诊断价值[J].山东大学学报(医学版),2017,55(3):112-116.
[7]GuptaA,KesavabhotlaK,BaradaranH,etal.Plaque Echolucency and Stroke Risk in Asymptomatic Carotid Stenosis:A Systematic Review and Meta-Analysis[J].Stroke,2015,46(1):91-97.
[8]李军.血压变异性患者血浆纤维蛋白原与动脉粥样斑块的关系[J].中国现代药物应用,2014,8(12):93-94.
[9]黎舒,柯振符,宁学洪.急性进展性脑梗死患者血浆纤维蛋白原及D-二聚体含量的测定及临床意义[J].医学检验与临床,2014,25(3):79,86.
[10] Boulos N M,Gardin J M,Malik S,et al.Carotid Plaque Characterization,Stenosis,and Intima-Media Thickness According to Age and Gender in a Large Registry Cohort[J].Am J Cardiol,2016,117(7):1185-1191.
[11] Piotr M,Wieslawa T,Lukasz T,et al.Multimarker Approach in Discriminating Patients with Symptomatic and Asymptomatic Atherosclerotic Carotid Artery Stenosis[J].J Clin Neurol,2013,9(3):165-175.
[12]张冰,解学军.幽门螺旋杆菌与颈动脉粥样硬化斑块和血浆脂蛋白相关磷脂酶A2水平的关系[J].赤峰学院学报(自然科学版),2015,31(10):190-192.
[13]费玲,张军,王长厚,等.冠状动脉斑块显像特征与妊娠相关血浆蛋白A水平的关系[J].中华老年心脑血管病杂志,2014,16(7):720-722.
[14]徐东强,刘硕,于成勇,等.血浆脂蛋白磷脂酶A2、同型半胱氨酸与缺血性脑卒中的研究进展[J].中国基层医药,2015,22(14):2218-2221.
[15]杨永海,顾永文,姚雪峰,等.通心络对单纯颈动脉斑块患者血浆超敏C反应蛋白和脂蛋白相关磷脂酶A2的影响[J].中国继续医学教育,2015,7(21):203-204.
[16] Ishiguro T,Yoneyama T,Ishikawa T,et al.Perioperative and Long-term Outcomes of Carotid Endarterectomy for Japanese Asymptomatic Cervical Carotid Artery Stenosis:A Single Institution Study[J].Neurol Med Chir(Tokyo),2015,55(11):830-837.
[17]艾民,颜昌福,夏福纯,等.颈动脉斑块积分、血浆同型半胱氨酸与冠状动脉病变程度的相关性[J].四川医学,2017,38(8):866-868.
[18]邓宇鲲,闫冰,陈涛,等.血浆同型半胱氨酸水平与颈动脉斑块相关性的研究[J].中国循环杂志,2014,29(5):363-366.
[19]顾汉沛,葛剑青,王光胜.血浆Lp-PLA2、HCY、尿酸与血脂对稳定大动脉粥样硬化性脑梗死病人颈动脉斑块的临床意义[J].中西医结合心脑血管病杂志,2017,15(5):613-616.
[20]马鑫,张晖.急性脑梗死患者血清纤维蛋白原血浆D-二聚体与颈动脉粥样硬化斑块的相关性研究[J].中国实用神经疾病杂志,2016,19(8):39-41.
[21]吕桂贤.急性脑梗死患者颈动脉粥样斑块稳定性与血浆脂联素、Lp-PLA2水平的关系[J].心血管康复医学杂志,2015,24(6):597-599.