老年急性脑梗死患者颈动脉粥样硬化新危险因素研究

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目的:研究老年急性脑梗死(ACI)患者颈动脉粥样硬化(CAS)新危险因素,为CAS的防治提供参考。方法:将162例ACI患者根据是否发生CAS分为无斑块组70例,斑块组92例,分别检测血糖、血脂、胆红素、C反应蛋白(CRP)、尿酸(UA)、纤维蛋白原(Fib)浓度,对上述指标与颈动脉内-中膜厚度(IMT)进行Spearman相关性分析。结果:两组血脂、血糖水平比较差异无统计学意义(P>0.05);斑块组总胆红素(TBIL)、间接胆红素(IBIL)浓度低于无斑块组(P<0.05),CRP、UA、Fib浓度高于无斑块组(P<0.05);CRP、UA、Fib浓度与IMT呈正相关(r1=2.84,r2=1.45,r3=1.98,均P<0.05),TBIL、IBIL浓度与IMT呈负相关(r4=-0.74,r5=-1.02,均P<0.05)。结论:老年ACI患者CRP、UA、Fib浓度升高参与了CAS发病与发展的过程,而TBIL、IBIL是IMT增厚的保护性因素。 Objective: To study the new risk factors of carotid atherosclerosis (CAS) in elderly patients with acute cerebral infarction (ACI) and provide reference for the prevention and treatment of CAS. Methods: A total of 162 patients with ACI were divided into two groups based on whether there was CAS or not: 70 cases in the plaque group and 92 cases in the plaque group. The blood glucose, blood lipids, bilirubin, C-reactive protein (CRP), uric acid (Fib) concentration, the Spearman correlation analysis of the above parameters and carotid intima-media thickness (IMT). Results: There was no significant difference in blood lipids and blood glucose between the two groups (P> 0.05). The concentrations of total bilirubin (TBIL) and indirect bilirubin (IBIL) in the plaque group were lower than those in the plaque group (P <0.05) (P <0.05). The concentrations of CRP, UA and Fib were positively correlated with IMT (r1 = 2.84, r2 = 1.45, r3 = 1.98, The concentration of IBIL was negatively correlated with IMT (r4 = -0.74, r5 = -1.02, both P <0.05). CONCLUSION: Elevated concentrations of CRP, UA and Fib in elderly patients with ACI are involved in the pathogenesis and progression of CAS. TBIL and IBIL are protective factors of IMT thickening.
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