老年动脉粥样硬化不稳定斑块患者多种生化指标的变化及意义

1510515〔〕、、。10564CT64-MSCTCT55、50CCRP、MDA、CD40sCD40L、HCY、FIB。CRP、MDAsCD40LFIBHCYP＜0.05LogisticsCD40、CRP、P＜0.05。CRP、HCY、FIB、MDA、sCD40LCRP、sCD40LCRPsCD40LsCD40L。〔〕X〔〕R541.4〔〕A〔〕1005-9202201209-1785-03doi10.3969/j.issn.1005-9202.2012.09.002Researchonthechangesandmeaningsofmulti-biochemicalindexesinelderlypatientswithunstableatheroscleroticplaquelesionLIUGong-LiWUSai-ZhuWANGQietal.DepartmentofCardiologyNanfangHospitalSouthernMedicalUniversityGuangzhou510515GuangdongChina【Abstract】ObjectiveToinvestigatethechangesandmeaningsofmulti-biochemicalindexesinoxidativestressinflammationim-muneandthrombosisinelderlypatientswithunstableatheroscleroticplaque.MethodsAccordingtothediagnosisby64multi-slicecom-puterizedtomography105patientsweredividedintostableplaquegroup55patientsunstableplaquegroup50patients.PlasmalevelofC-reactiveproteinCRPmalondialdehydeMDAhomocysteineHCYsolubleCD40ligandsCD40LandfibrinogenFIBweremeasuredforeachpatients.ResultsPlasmalevelsofCRPMDAHCYsCD40LFIBinunstableatheroscleroticplaquegroupweresig-nificantlyhigherthanthoseinstableplaquegroupP＜0.05LogisticregressionshowedthatonlyCRPsCD40smokingwereindepend-entlyassociatedwithunstableatheroscleroticplaquelesion.ConclusionsThereisamarkedrelationshipbetweenupregulationofCRPMDAsCD40Llevelsandunstableatheroscleroticplaquelesion.AndplasmalevelsofCRPsCD40Lareassociatedwithunstableplaquesle-sionswhichcouldhavegreatpotentialtopredictunstableatheroscleroticplaquelesion.【Keywords】BiochemicalindexUnstableplaqueCarotidarteryTomographyX-raycomputedElderlypatients“973”2007CB50740411962-。1982-。。。。11.12010420118、CT105624360～79〔67.9±4.6〕CTn=55、n=50。1、Ⅲ～Ⅳ。、、、、P＞0.05P＜0.05。1。1.21.2.1SBP、DBP、、、、、。1.2.2CT64CT。CT≥120HUCT50～119HU≥80%≤50HUCT50～119HU＜80%。1x±sn=55n=50tχ2P67.6±4.268.2±5.00.6640.5083054.53264.00.9680.325〔n%〕3970.93060.01.3830.2402〔n%〕1730.92142.01.3950.238〔n%〕2545.51938.01.7900.410〔n%〕1629.12448.013.9710.046TGmmol/L1.96±0.991.89±0.70－0.4030.688TCmmol/L5.76±0.946.01±1.041.2890.200LDL-Cmmol/L3.77±0.864.01±0.961.3680.174HDL-Cmmol/L1.22±0.281.13±0.26－1.7490.0831P＜0.051.2.324h3～4ml－40℃。sCD40LELISAMDACRPFIBHCY。1.3SPSS13.0。x±stχ2Logistic。22.1CRP、MDA、sCD40L、FIBHCYP＜0.05。2。2MDA、sCD40L、CRP、FIBHCYx±sn=55n=50MDAng/ml4.76±0.905.46±1.032CRPmg/L3.71±1.565.87±1.142FIBg/L3.47±1.434.00±1.221sCD40Lng/ml5.10±0.606.50±0.942HCYμmol/L19.14±3.7821.06±4.3411P＜0.052P＜0.012.2Logistic。sCD40、CRP、P＜0.05。3。3LogisticOR95%CIPsCD401.9231.288～2.8710.001CRP3.8181.685～8.6530.0013.8691.203～12.430.0233〔1〕。〔2〕。CRP＞3mg/L〔3〕。Sivja〔4〕CRP。HCYCD40-CD40LMMP〔5〕。FIB〔6〕。MDA-LDL〔7〕。IVUS、、、。CRP、MDA、sCD40L、FIBHCYLogisticCRP、sCD40L。。CRP。CD40-CD40LCD40LsCD40LsCD40〔5〕。“”ACSCD40L〔8〕。Li〔9〕sCD40L、、。sCD40L。41LibbyP.Inflammationinatherosclerosis〔J〕.Nature20024206868-74.2BlakeGJRidkerPM.C-reactiveproteinandotherinflammatoryriskmarkersinacutecoronarysyndromes〔J〕.JAmCollCardiol200341437-42.3YehETAndersonHVPasceriVetal.C-reactiveproteinlinkingin-flammationtocardiovascularcomplications〔J〕.Circulation20011049974-5.4NorjaSNuutilaLKarhunenPJetal.C-reactiveproteininvulnerablecoronaryplaques〔J〕.JClinPathol2007605545-8.·6871·20125325VaroNdeLemosJALibbyPetal.SolubleCD40Lriskpredictionafteracutecoronarysyndromes〔J〕.Circulation200310891049-52.6.C〔J〕.20052513-5.7ArakiTKanayaHShimizuMetal.Changesinserummalondial-de-hyde-modifiedlow-densitylipoproteininpatientswithacutemyocardialinfarctionandstableanginapectoristreatedbycoronaryangioplasty〔J〕.JCardiol200138255-60.8LiGSandersJMBevardMHetal.CD40ligandpromotesMac-1expres-sionleukocyterecruitmentandneointimaformationaftervascularinjury〔J〕.AmJPathol200817241141-52.9.〔J〕.2006346512-4.〔2011-10-282012-01-10〕/450052〔〕。MRI120MoCAScheltens。4278Mo-CA22.44±3.4728.42±1.13P＜0.05。Scheltens8.01±2.502.49±0.59P＜0.05ScheltensMoCA0.869P＜0.05。Scheltens。〔〕Scheltens〔〕R74〔〕A〔〕1005-9202201209-1787-03doi10.3969/j.issn.1005-9202.2012.09.003TherelationshipbetweenwhitematterlesionsandcognitivedysfunctionJIANGChaoWANGJian-Ping.DepartmentofNeurologytheFifthAffiliatedHospitalofZhengzhouUniversityZhengzhou450052HenanChina【Abstract】ObjectiveTostudytherelationshipbetweenwhitematterlesionsandcognitivedysfunction.Methods120patientswithwhitematterlesionswererandomlyselectedaccordingtotheirMRIresults.Allpatientsweredividedintopatientswithorwithoutcogni-tivedysfunctionaccordingtotheresultsofMoCAscale.Scheltenssemi-quantitativeevaluationwasusedtodetectthedamagedegreeofwhitematter.Correlationanalysiswasusedtoevaluatetherelationshipbetweenwhitematterlesionsandcognitivedysfunction.ResultsTherewere42patientswithcognitivedysfunctionand78patientswithoutcognitivedysfunction.TheresultsofMoCAscaleforthesetwogroupswere22.44±3.47and28.42±1.13respectively.Scheltenssemi-quantitativeevaluationforpatientswithwhitematterlesionsandpatientswith-outwhitematterlesionswere8.01±2.50and2.49±0.59respectively.TherewassignificantdifferencebetweenthistwogroupsP＜0.05.ThecorrelationcoefficientofScheltenssemi-quantitativeresultsandMoCAscalewas0.869P＜0.05.ConclusionsWhitemat-terinjurycouldleadtocognitivedysfunction.Scheltenssemi-quantitativeevaluationhasimportant