脑梗死患者颈动脉粥样硬化及胆红素及尿酸关系.docVIP

脑梗死患者颈动脉粥样硬化及胆红素及尿酸关系 　【摘要】 目的:分析脑梗死患者颈动脉粥样硬化与胆红素和尿酸的关系。方法:177例脑梗死患者行彩色多普勒超声检测颈动脉内中膜厚度(IMT)并观察颈动脉有无斑块，根据结果分成斑块组(颈动脉IMT＞1.2 mm和/或有颈动脉斑块)和无斑块组(颈动脉IMT≤1.2 mm且无颈动脉斑块)，分析两组间胆红素和尿酸的差异。结果:斑块组血尿酸明显高于无斑块组，差异有显著性(Plt;0.05)。Logistic多元回归分析发现，血清胆红素、尿酸均为脑梗死患者颈动脉粥样硬化的独立危险因素。结论:在脑梗死患者颈动脉粥样硬化的发生发展中，血清胆红素、尿酸起了非常重要的作用。 【关键词】 颈动脉内中膜厚度；颈动脉粥样硬化；胆红素；尿酸 Abstract: Objective: To analyze the relationship among serum bilirubin, uric acid and carotid atherosclerosis in patients with cerebral infarction. Methods:Totally 177 patients with cerebral infarction were examined with B-type ultrasound to measure intima-media thickness (IMT) of the common carotid artery and plaque formation．The patients were divided into plaque group (carotid IMT＞1.2 mm and/or the presence of carotid plaque) and group without plaque (carotid IMT≤1.2 mm and the absence of carotid plaque)．The differences of serum uric acid and bilirubin between two groups were analyzed. Results:The level of uric acid in plaque group was significantly higher than that in group without plaque (Plt;0.05). The result of logistic regression analysis indicated that serum bilirubin， uric acid were the independent risk factors. Conclusion: Both serum bilirubin and uric acid are strongly and closely related to the occurrence and development of carotid atherosclerosis in patients with cerebral infarction. Key words: carotid intima-media thicknes；carotid atherosclerotic plaque；uric acid; bilirubin 动脉粥样硬化斑块是脑梗死和冠状动脉粥样硬化性心脏病(冠心病)等各种血管事件的主要危险因素，虽然颈动脉内膜剥离术等技术的使用能够及时有效地干预颈动脉斑块,降低脑卒中的危险，但就人群而言，寻找动脉粥样硬化斑块形成的危险因素，降低斑块的发生率，可以带来更大的社会效益。国内外有关动脉粥样硬化和胆红素、尿酸的关系研究较少，而血管超声无创、经济、易操作、可反复检查，是颈部动脉病变检查的重要手段。本研究旨在通过颈动脉彩色超声检查探讨脑梗死患者颈动脉粥样硬化斑块与胆红素和尿酸的关系，为防治脑卒中提供理论依据。 1 资料和方法 1.1 临床资料 选择2006年4月至10月在我院住院的脑梗死病例202例。脑梗死的诊断符合第四届全国脑血管病会议修订的标准，全部病例均经头颅CT或MRI扫描证实。选择动脉粥样硬化性脑梗死病例177例,所有病例均行颈动脉彩色超声检查。根据颈动脉彩色超声检查的结果,分成斑块组和无斑块组。 1.2 超声检查和检测指标 全部病例颈动脉超声检测均由专人操作，使用HP-Sonos 5500彩色超声诊断仪，探头频率为7.5 MHz。患者采用仰卧位，头偏向颈部检查对侧，充分暴露检查部位，常规检查双侧颈总动脉(CCA)、颈动脉膨大至分叉(BIF)、颈内动脉(ICA)。记录颈总动脉内中膜厚度以及粥样硬化斑块