Correlative Study On Carotid Atherosclerosis In Patients With Cerebral Infarction And CRP, Blood Lipid And Fibrinogen

Object and MethodAtherosclerosis is a major pathologic basis of cerebral infarction (CI). Carotid atherosclerotic is closely linked with the incidence of cerebral infarction. The instabile plaque rupture is important to take the links. However, there are many factors involved in plaque formation. To study and research serum C-reactive protein (CRP) level and fibronogen (FIB) have been a hot spot in recent year. The scholars have confirmed its effect from different point of view in pathogenesis of atherosclerosis. It is no deny that dyslipidemia is still one of most dangerous reasons of atherosclerosis. To deepen the pathogenesis of atherosclerosis in the study, the relationship between carotid artery plaque and cerebral infarction. We study through a prospective observation 92 serum index and carotid Color Doppler ultrasonography of cases selected who were in-patient patients in the First Hospital of Jilin University from Jan, 2006 to Feb, 2007. Data were compared in age and gender etc within pair group, where comparability existed. All patients who suffered CI were divided into plaque formation group and no plaque group by ultrasonography or stabilization plaque group and destabilization plaque group by ultrasonography. To observe the incidence of carotid plaque in infarct side and no infarct side and the results were statistically analyzed.ResultsThe incidence of carotid atherosclerosis is high, accounting for 75% of plaque in carotid artery bifurcation prone in patients with cerebral infarction, most of patches are found on the bifurcations (BIF) of carotid, frequently showing a flat-sharp plaque. Severe carotid narrowing by atherosclerotic plaque caused is less, most of destabilization plaque occurs at the same side of infarct side. There is no significant difference between the infarct side and no infarct side (P<0.05). The contents of CRP,FIB,TC,LDL in plaque group is higher than that of no plaque group, but the content of HDL in no plaque group is lower than that of plaque group. There is significant difference between the two groups (P<0.05). The contents of CRP and TG in destabilization plaque group is higher than that of stabilization plaque group among every index to compare, there is statistic difference between two groups. At the group of older than 60 years old FIB are higher than that of at the group of younger than 60 years old. There is significant difference between the two groups (P<0.05). The incidence of destabilization plaque in multiple lesions is higher than that of single lesion, the incidence of destabilization plaque in palindromia lesions is higher than that of the first lesions. The statistic difference is obviously existed between foregoing two groups (P<0.05). The serum concentration of CPRof the large area infarct group is highest among three groups. In contrast, the contents of FIB of lacunar infarction is significantly higher than the other two groups, lipid no difference (P> 0.05).Conclusions(1) Heighten of serum CRP level is related to carotid atherosclerosis, particularly heighten of serum CRP level is closely related to unstable plaque formation(2) Heighten of serum CRP level can reflect serious degree of CI, which is a index of prognostic evaluation.(3)The higher serum TC,LDL level and the lower serum HDL level are prone to evolve to the rupture of atherosclerotic spots. (4) Serum FIB level of lacunar infarction is higher than that of other types of CI.We consideration that heighten of blood viscosity by FIB caused play a important role in atherosclerosis and the formation of CI, but there is no significant difference between the stabilization and destabilization plaque group.(5)The incidence of carotid atherosclerosis in CI patients is high, most of carotid atherosclerotic plaque are found on the bifurcations (BIF) site of carotid, frequently showing a flat-sharp and hard to spot plaque types.(6)Severe carotid narrowing(more than 70% of carotid were blocked) by atherosclerotic plaque caused is less, which has poor relationship between carotid lesions and cerebral infarction; Cerebral embolism by destabilization plaque defluxioed is majority.Therefore, the nature of atherosclerotic plaque is more close relationship than carotid narrowing in pathogenesy of CI.(7) The incidence of destabilization plaque in multiple lesions and palindromia lesions is higher than opposite groups, so we may make carotid sonography and take effective defence and treatment in time.(8) Color Doppler ultrasonography is simple, economic, non-invasive and easy repeatability, and it has become necessary for detection of cerebral infarction patients and the health examination of conventional items.