血管内皮功能与急性脑梗死患者梗死类型及颈动脉斑块性质的相关性

目的:研究急性脑梗死(ACI)患者血管内皮功能的变化情况,并分析其与脑梗死类型及颈动脉斑块性质的相关性。方法:选择2014年6月到2015年6月在我院收治的脑梗死患者100例作为研究对象。根据病史及磁共振成像(MRI)诊断结果分为ACI组(n=70)和非急性脑梗死(NACI)组(n=30),对两组患者间的血管内皮细胞功能的相关指标进行比较,同时按照梗死类型以及颈动脉斑块性质不同对ACI组进行分组,探究梗死类型与斑块性质与反应性充血指数(RHI)的相关性。结果:ACI组纤维蛋白原(Fbg)、低密度脂蛋白(LDL)、大内皮素-1(big ET-1)、超敏C反应蛋白(hs-CRP)和内皮细胞生长因子(VEGF)水平均高于NACI组,RHI水平低于NACI组,差异有统计学意义(P0.05)。不同急性脑梗死TOAST分型中心源性栓塞型(CE)、小血管闭塞或腔隙性梗死型(SAA)、不明原因型(SUE)和大动脉粥样硬化型(LAA)测得RHI水平逐渐上升,hs-CRP水平和big ET-1水平逐渐下降,差异具有统计学意义(P0.05);比较不同斑块性质发现无斑块组、硬斑块组、软斑块组和混合斑块组的VEGF水平逐渐升高,RHI水平逐渐降低,差异均有统计学意义(P0.05)。相关性分析显示,RHI与斑块性质、hs-CRP以及big ET-1之间呈现负相关(r=-0.672,-0.402,-0.512,P0.05)。结论:血管内皮功能与急性脑梗死类型和颈动脉斑块性质有相关性,可作为评估梗死类型和斑块性质的预测指标。

Correlation between Vascular Endothelial Function and Carotid Artery Plaque in Patients with Acute Cerebral Infarction

Objective:To study the changes of vascular endothelial function in patients with acute cerebral infarction (ACI),and to analyze its correlation with the types of cerebral infarction and carotid plaque.Methods:Selected 100 cases of patients with cerebral infarction who were treated in our hospital were selected as objects, and were divided into ACI group (n=70) and non-acute cerebral infarction(NACI) group(n=30) by the diagnostic results of history and magnetic resonance imaging(MRI), compared the endothelial cell functions of patients between the two groups. Then the ACI group was divided into groups by the type of infarction and carotid plaque, explored the correlation between infarct type and plaque characteristics and reactive congestion indexes (RHI).Results:The levels of fibrinogen (Fbg), low density lipoprotein (LDL), big endothelin (big ET-1), hypersensitive C-reactive protein (hs-CRP) and vascular endothelial growth factor(VEGF)of patients in ACI group were higher than NACI group,the level of RHI was lower than NACI group,the differences were statistically significant (P<0.05). In the cardioembolism (CE), small-artery occlusion lacunars (SAA), stroke of undetermined etiology (SUE)and large-artery atherosclerosis (LAA)of different types of ACI TOAST, the levels of RHI were gradually increased, but the levels of hs-CRP and big ET-1 were gradually decreased, the differences were statistically significant (P<0.05); Compared the different patch properties, the levels of VEGF in non plaque group, hard plaque group, soft plaque group and mixed plaque group were increased in turn,and the levels of RHI were decreased in turn, the differences were statistically significant (P<0.05). Correlation analysis showed that RHI were negatively correlated with the type of plaque, the level of hs-CRP and big ET-1 (r=-0.672, -0. 402, -0.512, P<0.05).Conclusion:Vascular endothelial function is associated with acute cerebral infarction and carotid artery plaque, which can be used as a predictor for evaluating infarct types and properties.