【摘要】 目的 分析老年急性脑梗死患者红细胞分布宽度(red blood cell distribution width, RDW)和血脂代谢指标与颈动脉粥样硬化斑块稳定性的关系。方法 回顾性分析2021年3月至2024年11月芜湖市中医医院收治的老年急性脑梗死患者110例，根据颈动脉斑块特征分为稳定斑块组48例和不稳定斑块组62例。检测RDW、总胆固醇(total cholesterol, TC)、三酰甘油(triacylglycerol, TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol, HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol, LDL-C)、同型半胱氨酸(homocysteine, Hcy)水平。结果 不稳定斑块组RDW、TC、TG、LDL-C、Hcy水平明显高于稳定斑块组，HDL-C水平明显低于稳定斑块组(P<0.01)。RDW、TC、TG、HDL-C、LDL-C、Hcy是老年急性脑梗死患者颈动脉粥样硬化斑块稳定性的影响因素(P<0.05,P<0.01)。RDW、TC、TG、HDL-C、LDL-C、Hcy水平联合检测评估颈动脉粥样硬化斑块稳定性ROC曲线下面积为0.940(95%CI:0.898～0.983),明显优于各指标单独检测(P<0.05)。结论 老年急性脑梗死患者RDW、血脂代谢指标与颈动脉粥样硬化斑块稳定性相关，可作为颈动脉粥样硬化斑块稳定性的生化评估指标。更多还原

【Abstract】 Objective To analyze the relationship of red blood cell distribution width(RDW) and blood lipid metabolism indicators with carotid atherosclerotic plaque stability in elderly patients with acute cerebral infarction(ACI).Methods A total of 110 elderly ACI patients admitted in our hospital from March 2021 to November 2024 were retrospectively recruited, and according to their carotid plaque characteristics, they were divided into stable plaque group(48 cases) and unstable plaque group(62 cases).The RDW,and levels of TC,TG,HDL-C,LDL-C and homocysteine(Hcy) were detected.Results The unstable plaque group had significantly higher levels of RDW,TC,TG,LDL-C and Hcy, but lower HDL-C level than the stable plaque group(P<0.01).RDW,TC,TG,HDL-C,LDL-C and Hcy were the influencing factors of carotid atherosclerotic plaque stability in elderly ACI patients(P<0.05,P<0.01).ROC curve analysis suggested that the AUC value of combined detection of RDW,TC,TG,HDL-C,LDL-C and Hcy in evaluating the stability of carotid atherosclerotic plaque was 0.940(95%CI:0.898～0.983),and the combination had better efficiency than single indicator detection(P<0.05).Conclusion RDW and blood lipid metabolism indicators are associated with the stability of carotid atherosclerotic plaque in elderly ACI patients, and they can be used as biochemical evaluation indicators for the stability.更多还原