目的 探討分支動(dòng)脈粥樣硬化病患者血清生化指標(biāo)水平與進(jìn)展性腦梗死的相關(guān)性。方法 收集2015年1月-2017年6月廊坊市人民醫(yī)院收治的分支動(dòng)脈粥樣硬化病患者138例的臨床資料，根據(jù)病情變化將患者分為進(jìn)展組和非進(jìn)展組，其中進(jìn)展組為出現(xiàn)病情進(jìn)展者50例，從其他88例患者中隨機(jī)選取50例納入非進(jìn)展組。所有患者入院當(dāng)日均進(jìn)行卒中神經(jīng)功能缺損評估。次日晨兩組患者均予空腹抽血常規(guī)檢查血生化、血脂全項(xiàng)等各項(xiàng)指標(biāo)。整理所有患者的血液檢查指標(biāo)同型半胱氨酸（Hcy）、C反應(yīng)蛋白（CRP）、纖維蛋白原（Fib）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、LDL與HDL的濃度比值（LDL/HDL）、膽固醇、白蛋白、總蛋白結(jié)果，分析不同血清生化指標(biāo)水平與分支動(dòng)脈粥樣硬化病進(jìn)展性腦梗死的相關(guān)性情況。結(jié)果 進(jìn)展組患者入院時(shí)和進(jìn)展癥狀穩(wěn)定后的NIHSS評分差值較大，非進(jìn)展組入院時(shí)和出院時(shí)NIHSS評分差值較小，兩組患者的NIHSS評分差值比較，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。進(jìn)展組患者的血清Hcy、CRP、Fib、LDL/HDL比值均高于非進(jìn)展組，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；兩組患者的血清LDL、HDL、膽固醇、白蛋白、總蛋白無顯著差別。結(jié)論 高濃度的Hcy、CRP、Fib和LDL/HDL高比值是分支動(dòng)脈粥樣硬化病進(jìn)展性腦梗死的危險(xiǎn)因素，有助于早期識別和及時(shí)治療進(jìn)展性分支動(dòng)脈粥樣硬化病。

Objective To investigate the correlation between serum biochemical markers and progressive cerebral infarction of branch atheromatous disease. Methods Patients (138 cases) with branch atheromatous disease in the People's Hospital of Langfang City from January 2015 to June 2017 were randomly divided into progress and non-progress groups according to the change of the condition, and each group had 50 cases. All patients were assessed with neurological deficits in cerebral infarction on admission day. The next morning, two groups of patients were carried on blood test taken on an empty stomach of blood biochemistry, blood lipids, and other indicators. Hcy, CRP, Fib, LDL, HDL, LDL/HDL ratio, Cholesterol, albumin, and total protein were collected, and the correlation between serum biochemical indexes and progressive cerebral infarction of branch atheromatous disease was analyzed. Results The difference of NIHSS score after admission and stable progression symptoms of progress group was greater, but the difference of NIHSS score at admission and at discharge of non-progress group was small, and the difference was statistically significant between two groups (P<0.05). Compared with the non-progress group, the serum level of Hcy, CRP, Fib, and LDL/HDL ratio in the progress group were significantly increased, with significant difference between two groups (P<0.05). There were no significant differences in LDL, HDL, cholesterol, albumin, and total protein concentrations between two groups. Conclusion High concentrations of Hcy, CRP, Fib, and high LDL/HDL value are risk factors for progressive cerebral infarction of branch atheromatous disease, and it is helpful for early identification and timely treatment of progressive branch atherosclerosis.

廊坊市科學(xué)技術(shù)研究與發(fā)展計(jì)劃項(xiàng)目（2013013008C）