【摘要】 目的探讨急性脑梗死患者颈动脉粥样硬化斑块稳定性与血清YKL-40水平之间的相关性,为颈动脉粥样硬化及脑梗死的早期诊治提供临床依据。方法选取95例急性脑梗死患者为研究对象,按照颈动脉彩超检查结果将脑梗死组分为不稳定斑块组、稳定斑块组和无斑块组。选取同期健康体检人员50例为对照组。采用双抗体夹心酶联免疫法检测急性脑梗死患者入院48 h、入院14 d及对照组血清YKL-40水平,比较不同时期不同性质颈动脉斑块血清YKL-40的差异。结果脑梗死组患者血清YKL-40水平明显高于正常对照组,且不稳定斑块组血清YKL-40的水平>稳定斑块组>无斑块组,差异均具有统计学意义(P<0.05),脑梗死各亚组入院14 d血清YKL-40水平均低于入院48 h血清值,差异有统计学意义(P<0.05)。YKL-40的水平与梗死面积、NIHSS、胆固醇、血压、GLU、LDL-C、TG呈正相关(P<0.05)。结论血清YKL-40是AS形成的重要标志物,与动脉粥样硬化斑块的稳定性相关。血清YKL-40可以监测动脉粥样硬化的程度,从一定程度上预测脑梗死发生的风险。更多还原

【Abstract】 Objective To investigate the relationship between carotid atherosclerotic plaque stability and serum YKL-40 in patients with acute cerebral infarction,provide the evidences from clinical practice for stroke unit. Methods We selected 95 patients with acute cerebral infarction. Then according to the results of carotid artery ultrasonography,stroke group was divided into vulnerable plaques group( VP) 29 cases,stable plaques group( SP) 31 cases and no plaques group( NP) 35 cases. Control group: 50 cases of healthy persons. Through measured serum YKL-40 by using ELISA within 48 hours of onset and the 14 th day. Compared the differences of the serum YKL-40 in carotid plaques at diverse times. Results Serum YKL-40 in stroke group were significantly higher than the control group,and the levels of YKL-40 in unstable plaque levels > stable plaques > without plaque,the differences were significantly different( P < 0. 05). The YKL-40 of acute cerebral infarction subgroups in the 48 hours of onset were all higher than the 14 th day,the differences were significantly different( P < 0. 05). The level of YKL-40 were correlated with infarct size、NIHSS、cholesterol、blood pressure、GLU、LDLC、TG( P < 0. 05). Conclusion Serum YKL-40 is an important marker of atherosclerosis associated with stability of atherosclerotic plaques. Serum YKL-40 can monitor the extent of atherosclerosis,and predict the risk of cerebral infarction occurrence to some extent.更多还原