脑卒中高危人群无症状颈动脉斑块易损性与实验室指标的关系及对脑血管缺血事件发生的影响

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Abstract Objective To investigate the relationship between vulnerability of asymptomatic carotid artery plaque, laboratory indicators and influence on the occurrence of cerebrovascular ischemic events in high-risk patients with stroke.Methods The clinical data of 120 patients with asymptomatic carotid plaque who underwent stroke screening in Dongguan Songshan Lake Central Hospital from June 2017 to June 2020 were retrospectively reviewed. According to the results of carotid ultrasound, all patients with high risk of stroke were divided into stable plaque group (n=71) and vulnerable plaque group (n=49). The basic data and laboratory index levels of the two groups were compared, and the risk factors of cerebral ischemic events in the high-risk population of stroke were analyzed. Results There were no significant differences in levels of fasting blood glucose (FPG), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and homocysteine (Hcy) in peripheral blood between stable plaque group and vulnerable plaque group (P>0.05). The levels of low-density lipoprotein cholesterol (LDL-C) and cystatin C (CysC) in peripheral blood in vulnerable plaque group were higher than those in stable plaque group, and the differences were statistically significant (P<0.05). Univariate analysis showed that there were no significant differences in gender, age, body mass index, FPG, TC, TG, HDL-C and Hcy between two groups (P>0.05). There were statistically significant differences in plaque properties, LDL-C and CysC levels (P<0.05). Multivariate analysis showed that the levels of vulnerable plaques(β=1.784, OR=2.546, 95%CI=1.734-2.996), LDL-C (β=1.695, OR=2.198, 95%CI=1.453-2.760) and CysC (β=1.564,OR=1.754, 95%CI=1.176-2.488) were independent risk factors for cerebral ischemic events in high-risk stroke population (P<0.05). Conclusion Patients at high risk of stroke complicates with vulnerable asymptomatic carotid artery plaque have abnormal levels of LDL-C and CysC, which are independent risk factors for subsequent cerebral ischemic events.

Key words： People at high risk of stroke Asymptomatic carotid plaque Vulnerability Cerebrovascular ischemic event

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