急性脑梗死患者血清可溶性肿瘤坏死因子样弱凋亡诱导剂水平与颈动脉粥样硬化及硬化程度的关系分析-现代医学

急性脑梗死患者血清可溶性肿瘤坏死因子样弱凋亡诱导剂水平与颈动脉粥样硬化及硬化程度的关系分析

单位：1. 中国人民解放军252医院神经内科, 河北保定 071000;
2. 保定市第一中心医院神经内三科, 河北保定 071000

分类号：R743.33;R543.5

出版年·卷·期（页码）：2019·38·第九期（1108-1112）

摘要：

目的：观察急性脑梗死患者血清可溶性肿瘤坏死因子样弱凋亡诱导剂（sTWEAK）水平与颈动脉粥样硬化及硬化程度的关系。方法：随机选择2017年1月至2018年6月住院治疗的急性脑梗死合并颈动脉粥样硬化患者80例进行临床研究，所有患者均给予颈动脉血管超声检查和sTWEAK水平检测，观察不同分级的颈动脉斑块面积、斑块数目、斑块特征和斑块狭窄程度的患者sTWEAK水平。结果：不同颈动脉斑块面积患者sTWEAK水平差异有统计学意义（P<0.05），其中3级患者sTWEAK水平最高，0级患者水平最低。颈动脉斑块单发患者sTWEAK水平明显低于多发患者，颈动脉稳定斑块患者sTWEAK水平明显低于不稳定斑块患者，且差异具有统计学意义（P<0.05）。不同颈动脉狭窄程度的患者，其sTWEAK水平差异有统计学意义（P<0.05），其中轻度狭窄患者的sTWEAK水平最低，完全闭塞患者水平最高。使用Spearman等级相关分析观察多sTWEAK水平与颈动脉斑块面积、个数和颈动脉狭窄程度的相关性发现，多sTWEAK水平与三者均正负相关，其中与狭窄程度相关性最高。结论：急性脑梗死患者血清sTWEAK水平与颈动脉粥样硬化程度具有相关性，随动脉硬化程度加重而升高，能够成为临床颈动脉粥样硬化诊断和疗效评价的依据之一。

Objective:To investigate the relationship between serum soluble tumor necrosis factor-like weak apoptosis inducer(sTWEAK) level and carotid atherosclerosis as well as degree of atherosclerosis in patients with acute cerebral infarction.Methods:80 patients of acute cerebral infarction complicated with carotid atherosclerosis were randomly selected from January 2017 to June 2018. Carotid artery ultrasound examination and sTWEAK detection were performed in all patients. The sTWEAK level in patient with different grade of area, number, characteristics and stenosis severity of carotid plaque was observed.Results:There was a significant difference in sTWEAK level of patients with different carotid plaque area(P<0.05). Wherein sTWEAK level in patients of grade 3 was the highest, and that of grade 0 was the lowest. The sTWEAK level in patients with single carotid plaque was significantly lower than that in patients with multiple carotid plaques, and sTWEAK level in patients with stable carotid plaques was significantly lower than that in patients with unstable plaques(P<0.05). There was a significant difference in sTWEAK level of patients with different carotid plaque stenosis severity(P<0.05). wherein sTWEAK level in patients of mild stenosis was the lowest, and that of complete occlusion was the highest. Spearman rank correlation analysis was used to observe the correlation between multiple sTWEAK levels and area, number as well as stenosis severity of carotid plaque. The results showed that sTWEAK level was either positively or negatively correlated with the factors, and the correlation between multiple sTWEAK levels and carotid artery stenosis severity was the most significant.Conclusion:The serum sTWEAK level in patients with acute cerebral infarction is correlated with the degree of carotid atherosclerosis and increases with the degree of atherosclerosis, which can be one of the bases for clinical diagnosis and curative effects of carotid atherosclerosis.

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