临床荟萃
臨床薈萃
림상회췌
Clinical Focus
2015年
12期
1375-1377
,共3页
斑块,动脉粥样硬化%半胱氨酸%C 反应蛋白质
斑塊,動脈粥樣硬化%半胱氨痠%C 反應蛋白質
반괴,동맥죽양경화%반광안산%C 반응단백질
plaque,atherosclerotic%cysteine%C-reactive protein
目的：探讨血浆同型半胱氨酸(homocysteine,Hcy)及超敏 C 反应蛋白(high-sensitivity C-reactive protein,hs-CRP)表达水平与老年颈动脉粥样斑块易损性的关系,评价其对颈动脉易损斑块的预测价值。方法入选经颈动脉彩色超声检查有颈动脉内膜(IMT)增厚或颈动脉斑块的入院患者126例,同时记录患者血压、血糖、糖化血红蛋白、血脂、血浆 Hcy 及 hs-CRP 表达水平。结果依据颈动脉内膜厚度及斑块声学特点,126例患者分为颈动脉内膜增厚组37例、稳定斑块组44例及易损斑块组45例。3组间血压、血糖、糖化血红蛋白、总胆固醇、高密度脂蛋白胆固醇比较差异无统计学意义；易损斑块组血浆 Hcy、hs-CRP 及低密度脂蛋白胆固醇(LDL-C)[(22.32±8.60)μmol/L,(9.78±3.16)mg/L,(3.28±0.31)mmol/L]表达显著高于稳定斑块组[(14.26±4.22)μmol/L,(4.32±3.56)mg/L,(2.32±0.44)mmol/L]及内膜增厚组[(14.02±4.61)μmol/L,(4.22±2.37)mg/L,(2.28±0.60) mmol/L ],稳定斑块组及内膜增厚组 Hcy、hs-CRP 及 LDL-C 表达水平差异无统计学意义(P >0.05)；血浆 Hcy、hs-CRP 水平与斑块易损性呈正相关(r 值分别为0.905、0.870,P <0.01),Hcy、hs-CRP 水平越高,颈动脉斑块越不稳定。结论血浆 Hcy、hs-CRP 与颈动脉粥样斑块的不稳定性有关,测定其表达水平可能对斑块易损性有预测价值。
目的：探討血漿同型半胱氨痠(homocysteine,Hcy)及超敏 C 反應蛋白(high-sensitivity C-reactive protein,hs-CRP)錶達水平與老年頸動脈粥樣斑塊易損性的關繫,評價其對頸動脈易損斑塊的預測價值。方法入選經頸動脈綵色超聲檢查有頸動脈內膜(IMT)增厚或頸動脈斑塊的入院患者126例,同時記錄患者血壓、血糖、糖化血紅蛋白、血脂、血漿 Hcy 及 hs-CRP 錶達水平。結果依據頸動脈內膜厚度及斑塊聲學特點,126例患者分為頸動脈內膜增厚組37例、穩定斑塊組44例及易損斑塊組45例。3組間血壓、血糖、糖化血紅蛋白、總膽固醇、高密度脂蛋白膽固醇比較差異無統計學意義；易損斑塊組血漿 Hcy、hs-CRP 及低密度脂蛋白膽固醇(LDL-C)[(22.32±8.60)μmol/L,(9.78±3.16)mg/L,(3.28±0.31)mmol/L]錶達顯著高于穩定斑塊組[(14.26±4.22)μmol/L,(4.32±3.56)mg/L,(2.32±0.44)mmol/L]及內膜增厚組[(14.02±4.61)μmol/L,(4.22±2.37)mg/L,(2.28±0.60) mmol/L ],穩定斑塊組及內膜增厚組 Hcy、hs-CRP 及 LDL-C 錶達水平差異無統計學意義(P >0.05)；血漿 Hcy、hs-CRP 水平與斑塊易損性呈正相關(r 值分彆為0.905、0.870,P <0.01),Hcy、hs-CRP 水平越高,頸動脈斑塊越不穩定。結論血漿 Hcy、hs-CRP 與頸動脈粥樣斑塊的不穩定性有關,測定其錶達水平可能對斑塊易損性有預測價值。
목적：탐토혈장동형반광안산(homocysteine,Hcy)급초민 C 반응단백(high-sensitivity C-reactive protein,hs-CRP)표체수평여노년경동맥죽양반괴역손성적관계,평개기대경동맥역손반괴적예측개치。방법입선경경동맥채색초성검사유경동맥내막(IMT)증후혹경동맥반괴적입원환자126례,동시기록환자혈압、혈당、당화혈홍단백、혈지、혈장 Hcy 급 hs-CRP 표체수평。결과의거경동맥내막후도급반괴성학특점,126례환자분위경동맥내막증후조37례、은정반괴조44례급역손반괴조45례。3조간혈압、혈당、당화혈홍단백、총담고순、고밀도지단백담고순비교차이무통계학의의；역손반괴조혈장 Hcy、hs-CRP 급저밀도지단백담고순(LDL-C)[(22.32±8.60)μmol/L,(9.78±3.16)mg/L,(3.28±0.31)mmol/L]표체현저고우은정반괴조[(14.26±4.22)μmol/L,(4.32±3.56)mg/L,(2.32±0.44)mmol/L]급내막증후조[(14.02±4.61)μmol/L,(4.22±2.37)mg/L,(2.28±0.60) mmol/L ],은정반괴조급내막증후조 Hcy、hs-CRP 급 LDL-C 표체수평차이무통계학의의(P >0.05)；혈장 Hcy、hs-CRP 수평여반괴역손성정정상관(r 치분별위0.905、0.870,P <0.01),Hcy、hs-CRP 수평월고,경동맥반괴월불은정。결론혈장 Hcy、hs-CRP 여경동맥죽양반괴적불은정성유관,측정기표체수평가능대반괴역손성유예측개치。
ABSTRACT:Objective To explore the correlation between homocysteine (Hcy),high-sensitivity C-reactive protein (hs-CRP)expression and carotid atherosclerotic plaques vulnerability in elder patients,evaluate their predictive value in carotid vulnerable plaque.Methods A total of 126 patients were recruited.The intima-media-thickness (IMT)and plaque of carotid artery were measured by ultrasound images.The blood pressure,blood glucose,lipids, Hcy and hs-CRP were tested.Results According to the ultrasonic diagnosis,all patients were divided into increased IMT group (n =37),stable plaque group (n =44)and vulnerable plaque group (n =45).There were no significant difference in blood pressure,blood glucose,total cholesterol and high-density lipoprotein cholesterol among three groups.Hcy,hs-CRP and low-density lipoprotein (LDL-C)were significantly higher in vulnerable plaque group than in the stable group and increased IMT group (22.32 ±8.60 μmol/L vs 14.26 ±4.22 μmol/L vs 14.02 ±4.61 μmol/L, 9.78 ±3.1 6 mg/L vs 4.32±3.56 mg/L vs 4.22±2.37 mg/L,3.48±0.31 mmol/L vs 2.62±0.44 mmol/L vs 2.68± 0.60 mmol/L,respectively)(P <0.05).There were no significant difference in Hcy and hs-CRP between increased IMT group and stable plaque group (P >0.05);Plasma Hcy and hs-CRP levels were positively associated with plaque progression (r = 0.905 and 0.870,respectivelty,P < 0.01 ),The higher the Hcy and hs-CRP,the more unstable carotid plaques.Conclusion Hcy and hs-CRP were associated with the instability of carotid atherosclerotic plaques and may be used to identify the plaques vulnerability.
