目的 探讨分支动脉粥样硬化病患者血清生化指标水平与进展性脑梗死的相关性。方法 收集2015年1月-2017年6月廊坊市人民医院收治的分支动脉粥样硬化病患者138例的临床资料，根据病情变化将患者分为进展组和非进展组，其中进展组为出现病情进展者50例，从其他88例患者中随机选取50例纳入非进展组。所有患者入院当日均进行卒中神经功能缺损评估。次日晨两组患者均予空腹抽血常规检查血生化、血脂全项等各项指标。整理所有患者的血液检查指标同型半胱氨酸（Hcy）、C反应蛋白（CRP）、纤维蛋白原（Fib）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、LDL与HDL的浓度比值（LDL/HDL）、胆固醇、白蛋白、总蛋白结果，分析不同血清生化指标水平与分支动脉粥样硬化病进展性脑梗死的相关性情况。结果 进展组患者入院时和进展症状稳定后的NIHSS评分差值较大，非进展组入院时和出院时NIHSS评分差值较小，两组患者的NIHSS评分差值比较，差异具有统计学意义（P<0.05）。进展组患者的血清Hcy、CRP、Fib、LDL/HDL比值均高于非进展组，差异具有统计学意义（P<0.05）；两组患者的血清LDL、HDL、胆固醇、白蛋白、总蛋白无显著差别。结论 高浓度的Hcy、CRP、Fib和LDL/HDL高比值是分支动脉粥样硬化病进展性脑梗死的危险因素，有助于早期识别和及时治疗进展性分支动脉粥样硬化病。

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.

廊坊市科学技术研究与发展计划项目（2013013008C）