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目的探讨脑梗死患者颈动脉内膜-中层厚度、粥样硬化斑块的形成与糖尿病、血脂紊乱及纤维蛋白原水平之间的关系,为临床诊断、治疗提供依据。方法采用彩色多普勒显像仪对62例脑梗死患者(其中23例糖尿病合并脑梗死)进行颈动脉超声检测,同时作血糖、血脂及纤维蛋白原检测。结果糖尿病组颈动脉内膜-中层厚度(IMT)及颈动脉斑块发生率,分别与非糖尿病组和健康对照组比较,均有明显差异。化验指标上总胆固醇(TC)、低密度脂蛋白(LDL-C)在三组间有差异性,糖尿病组与健康对照组的甘油三酯(TG)比较有差异性;高密度脂蛋白(HDL-C)、纤维蛋白原(FIB)在三组间无差异性。结论糖尿病是造成脑梗死患者的颈动脉内膜增厚及粥样硬化斑块形成的主要危险因素,糖尿病患者颈动脉超声检查可作为脑梗死早期预测的手段。脂类代谢紊乱,在影响颈动脉内膜增厚及斑块形成与脑梗死的发生有明显相关性。对病人进行降脂治疗,改善脂代谢紊乱,能预防和减少脑梗死的发生。
Objective To explore the relationship between carotid intima - media thickness, atherosclerotic plaque formation and diabetes mellitus, dyslipidemia and fibrinogen in patients with cerebral infarction and provide basis for clinical diagnosis and treatment. Methods Sixty-two patients with cerebral infarction (23 with diabetes mellitus complicated with cerebral infarction) underwent carotid ultrasonography with color Doppler imaging. Meanwhile, blood glucose, blood lipid and fibrinogen were detected. Results The carotid intima - media thickness (IMT) and carotid plaque incidence in diabetic group were significantly different from those in non - diabetic group and healthy control group respectively. The levels of total cholesterol (TC) and low-density lipoprotein (LDL-C) were different among the three groups. There was significant difference in triglyceride (TG) between diabetic group and healthy control group. High-density lipoprotein -C), fibrinogen (FIB) no difference between the three groups. Conclusions Diabetes mellitus is the main risk factor for carotid intima-media thickness and atherosclerotic plaque formation in patients with cerebral infarction. Carotid ultrasonography can be used as an early predictor of cerebral infarction in diabetic patients. Lipid metabolism disorders, in the impact of carotid intimal thickening and plaque formation and cerebral infarction have a significant correlation. Lipid-lowering treatment of patients to improve lipid metabolism disorders, can prevent and reduce the incidence of cerebral infarction.