彩色多普勒超声、HbA1c及hs-CRP联合检测对动脉粥样硬化脑梗死的诊断价值
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摘要
目的:探讨彩色多普勒超声、糖化血红蛋白A1(HbA1c)及超敏C反应蛋白(hs-CRP)联合检测在动脉粥样硬化脑梗死中的诊断价值。方法:选择我院2014.01~2017.01期间收治的85例脑梗死患者为观察组及40例健康人群为对照组,比较两组患者HbA1c、hs-CRP和IMT水平;依据IMT值将患者分为正常、轻度和重度动脉粥样硬化组,按照NIHSS评分将患者分为轻度、中度和重度神经功能障碍组,并比较不同分组之间HbA1c、hs-CRP水平。结果:观察组斑块检出率、HbA1c、hs-CRP和IMT值均显著高于对照组(P<0.05);稳定斑块组HbA1c、hs-CRP、IMT和同侧脑梗死发生率均显著低于不稳定斑块组(P<0.05);轻度、中度和重度神经功能障碍组及正常、轻度和重度动脉粥样硬化组HbA1c和hs-CRP水平组间两两比较差异显著(P<0.05),其中,重度最高。结论:HbA1c和hs-CRP结合颈动脉彩超检测有助于指导动脉粥样硬化脑梗死患者的临床治疗和预后。
Objective: To investigate the diagnostic value of Hb A1 c and hs-CRP combined with carotid ultrasonography in atherosclerotic cerebral infarction. Methods: 85 patients with cerebral infarction admitted from January 2014 to January 2017 were taken as observation group,40 healthy people in our hospital were taken as control group,the levels of Hb A1 c,hs-CRP and hs-CRP were compared in two groups. Patients were divided into normal,mild and severe atherosclerosis patients according to the IMT values,and into mild,moderate and severe neurological dysfunction according to the NIHSS score,their Hb A1 c,hs-CRP levels were compared. Results: Hb A1 c,hsCRP,IMT values in the observation group were significantly higher than those of the control group( P < 0. 05);The incidence of ipsilateral cerebral infarction,Hb A1 c,hs-CRP,IMT in the patients with stable plaque were significantly lower than those with unstable plaques( P < 0. 05); The difference of Hb A1 c and hs-CRP between the patients with mild,moderate and severe neurological dysfunction,and normal,mild and severe atherosclerosis patients were statistically significant( P < 0. 05) among which the highest degree was in the severe patients.Conclusion: Hb A1 c and hs-CRP combined with carotid ultrasonography can be helpful in guiding the clinical treatment and prognosis in patients with atherosclerotic cerebral infarction.
Objective: To investigate the diagnostic value of Hb A1 c and hs-CRP combined with carotid ultrasonography in atherosclerotic cerebral infarction. Methods: 85 patients with cerebral infarction admitted from January 2014 to January 2017 were taken as observation group,40 healthy people in our hospital were taken as control group,the levels of Hb A1 c,hs-CRP and hs-CRP were compared in two groups. Patients were divided into normal,mild and severe atherosclerosis patients according to the IMT values,and into mild,moderate and severe neurological dysfunction according to the NIHSS score,their Hb A1 c,hs-CRP levels were compared. Results: Hb A1 c,hsCRP,IMT values in the observation group were significantly higher than those of the control group( P < 0. 05);The incidence of ipsilateral cerebral infarction,Hb A1 c,hs-CRP,IMT in the patients with stable plaque were significantly lower than those with unstable plaques( P < 0. 05); The difference of Hb A1 c and hs-CRP between the patients with mild,moderate and severe neurological dysfunction,and normal,mild and severe atherosclerosis patients were statistically significant( P < 0. 05) among which the highest degree was in the severe patients.Conclusion: Hb A1 c and hs-CRP combined with carotid ultrasonography can be helpful in guiding the clinical treatment and prognosis in patients with atherosclerotic cerebral infarction.
引文
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[12]王炎强,孙绍洋,张炳俊,等.大动脉粥样硬化性首发急性缺血性卒中的危险因素与分布特点[J].中国神经精神疾病杂志,2016,42(4):222-227.
[2]杨继党,林清原.糖化血红蛋白及高敏C反应蛋白与脑梗死急性期患者颈动脉粥样硬化的关系[J].中华神经医学杂志,2013,12(3):286-288.
[3]毕小丽,胡建芳.糖化血红蛋白水平与急性脑梗死神经功能缺损程度及其预后的相关性[J].广东医学,2013,34(4):564-566.
[4]陈庆康,石挥扬,曾广绥,等.颈动脉超声在老年脑梗死患者粥样硬化斑块的临床诊断价值[J].实用医学杂志,2015,31(14):2360-2361.
[5]HELDNER M R,ZUBLER C,MATTLE H P,et al.National institutes of health stroke scale score and vessel occlusion in2152 patients with acute ischemic stroke[J].Stroke,2013,44(4):1153-1157.
[6]卢新政.2007年欧洲高血压协会和欧洲心脏病学会高血压指南新亮点[J].中华高血压杂志,2007,15(9):708-710.
[7]李岩,王亚珍,郝志华,等.无糖尿病病史的体检者糖化血红蛋白与颈动脉内-中膜厚度及动脉粥样硬化的相关性研究[J].中国全科医学,2014,6(21):2440-2444.
[8]余求龙,徐丽君,闵珺,等.C-反应蛋白与动脉粥样硬化性脑梗死颈动脉内-中膜厚度的相关性[J].中国老年学杂志,2014,28(18):5062-5064.
[9]王圣龙,唐金荣.脑梗死患者同型半胱氨酸水平与颈动脉粥样硬化的相关性[J].川北医学院学报,2015,3(6):824-826.
[10]瞿萍,夏兰,陈贵海,等.炎症与脑梗死患者颈动脉粥样硬化关系的临床研究[J].河北医药,2010,32(13):1701-1702.
[11]王智明,李淮玉,李凤,等.颈动脉超声结合脂联素和超敏C反应蛋白在动脉粥样硬化脑梗死中的临床研究[J].实用医学杂志,2016,32(5):799-802.
[12]王炎强,孙绍洋,张炳俊,等.大动脉粥样硬化性首发急性缺血性卒中的危险因素与分布特点[J].中国神经精神疾病杂志,2016,42(4):222-227.