UA、Hcy和FIB与颈动脉粥样硬化斑块及脑梗死关系的分析
2019-10-21朱丽娜王宗立顾萌萌
朱丽娜 王宗立 顾萌萌
摘要：目的 探讨血清尿酸（UA）、同型半胱氨酸（Hcy）和血浆纤维蛋白原（FIB）水平与颈动脉粥样硬化及脑梗死的关系。方法 选择2017年10月～2018年10月在齐齐哈尔市第一医院住院的急性脑梗死患者作为研究对象，150例颈动脉粥样硬化脑梗死患者设为ACI组，根据颈动脉超声检查责任血管情况分为无斑块组30例、稳定斑块组48例和不稳定斑块组72例，另选同期120例健康者设为对照组。检测并比较各组血清UA、Hcy和血浆FIB水平，分析其与急性脑梗死的关系，ACI组中血清UA、Hcy和血浆FIB水平对颈动脉粥样硬化斑块的稳定性影响。结果 ACI组UA（379.78±86.54）μmol/L、Hcy（15.45±3.18）mmol/L和FIB（4.87±2.33）g/L水平均高于对照组的（248.47±74.43）μmol/L、（8.45±2.85）mmol/L和（2.37±0.58）g/L水平，差異有统计学意义（P<0.05）;不稳定斑块组UA（366.8±70.6）μmol/L、Hcy（17.36±3.52）mmol/L和FIB（5.28±2.43）g/L水平分别高于稳定斑块组及无斑块组，差异均有统计学意义（P<0.05）。结论 UA、Hcy和FIB的水平与急性脑梗死的发生密切相关，且与颈动脉粥样硬化斑块的不稳定性有关，因此三者联合检测对脑梗死的预防、诊断及治疗均有重要意义。
关键词：急性脑梗死;尿酸;同型半胱氨酸;纤维蛋白原
中图分类号：R743.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.18.061
文章编号：1006-1959（2019）18-0173-03
Abstract：Objective To investigate the relationship between serum uric acid（UA）， homocysteine （Hcy） and plasma fibrinogen（FIB） levels and carotid atherosclerosis and cerebral infarction.Methods From October 2017 to October 2018， patients with acute cerebral infarction admitted to the First Hospital of Qiqihar City were selected as subjects. 150 patients with carotid atherosclerotic cerebral infarction were enrolled in the ACI group， and 120 healthy subjects were selected. For the control group， according to the coronary artery ultrasound examination， the vascular condition was divided into 30 cases without plaque group， 48 cases with stable plaque group and 72 cases with unstable plaque group. The levels of serum UA，Hcy and plasma FIB were measured and compared. The relationship between serum UA，Hcy and plasma cerebral infarction was analyzed. The effects of serum UA，Hcy and plasma FIB levels on the stability of carotid atherosclerotic plaque in ACI group were analyzed.Results UA （379.78±86.54） μmol/L， Hcy （15.45±3.18） mmol/L and FIB （4.87±2.33） g/L in the ACI group were higher than that in the controlgroup（248.47±74.43） μmol/L，（8.45±2.85） mmol/L and （2.37±0.58） g/L， the difference was statistically significant （P<0.05）; unstable plaque group UA （366.8±70.6） μmol/L，Hcy （17.36±3.52）mmol/L and FIB （5.28±2.43） g/L were higher than those in the stable plaque group and the non-plaque group， respectively，the differences were statistically significant （P<0.05）.Conclusion The levels of UA，Hcy and FIB are closely related to the occurrence of acute cerebral infarction and are related to the instability of carotid atherosclerotic plaque. Therefore， the combined detection of these three factors is important for the prevention， diagnosis and treatment of cerebral infarction.
Key words：Acute cerebral infarction;Uric acid;Homocysteine;Fibrinogen
急性脑梗死（acute cerebral infarction，ACI）是神经系统常见疾病，也是最常见的脑卒中类型，指因脑组织局部血供障碍导致缺血缺氧，引发神经细胞坏死、凋亡，继而出现神经系统受损的表现。缺血性脑卒中具有较高的致残率和致死率，且近年来发病率呈逐年上升趋势，已成为严重影响患者生存质量和家庭社会负担的疾病之一[1]。目前高血压、高血脂、糖尿病等是脑梗死的独立危险因素已经得到公认，近年来报道尿酸、同型半胱氨酸和纤维蛋白原水平可能为新的脑梗死独立危险因素，本研究通过对这三项指标的测定分析，以探讨与颈动脉粥样硬化及急性脑梗死的关系。
1资料与方法
1.1一般资料 选择2017年10月～2018年10月齐齐哈尔市第一医院住院的急性脑梗死患者150例设为ACI组。……
