Grønholdt M L, Nordestgaard B G, Nielsen T G, Sillesen H
Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark.
Stroke. 1996 Dec;27(12):2166-72. doi: 10.1161/01.str.27.12.2166.
Echolucent carotid atherosclerotic plaques are associated with an increased risk of neurological symptoms. Elevated plasma triglycerides is a risk factor for cerebral and coronary infarction. This study examined these individual pathogenetic risk factors to determine whether they were related.
We included 85 symptomatic patients with at least 40% carotid artery stenosis. Plaque morphology of the relevant artery was evaluated by high-resolution B-mode ultrasonography as echolucent, echo-rich, or intermediate. Fasting and postprandial lipids and lipoproteins were measured before and at hourly intervals for 4 hours after a fatty meal (1 g cream fat per kilogram body weight).
When we compared patients with echolucent plaques to patients with echo-rich or intermediate plaques, the former had higher fasting and postprandial plasma triglycerides (P < or = .006), higher chylomicron remnants/VLDL cholesterol (P = .02) and triglycerides (P < or = .004), a larger area under the plasma triglyceride curve 0 to 4 hours after a fatty meal, with (AUCTG-TG oh) or without (AUCTG) subtraction of fasting levels (P = .007 and P = .003), a larger body mass index (P = .03), and were younger (P = .01). Multiple logistic regression analysis found that when age and body mass index were taken into account, fasting plasma and VLDL triglycerides, postprandial chylomicron remnants/VLDL triglycerides, AUCTG-TG oh and AUCTG with odds ratios of 4.1, 3.8, 3.0, 2.7, and 4.3, respectively, were independent predictors of an echolucent plaque.
Echolucent carotid artery plaques are associated with elevated levels of triglyceride-rich lipoproteins in the fasting or postprandial state.
颈动脉粥样硬化斑块呈低回声与神经症状风险增加相关。血浆甘油三酯升高是脑梗死和冠状动脉梗死的危险因素。本研究检测了这些个体致病风险因素，以确定它们是否相关。
我们纳入了85例有症状且颈动脉狭窄至少40%的患者。通过高分辨率B型超声评估相关动脉的斑块形态，分为低回声、高回声或中等回声。在进食脂肪餐（每千克体重1克奶油脂肪）前及进食后每小时测量空腹和餐后血脂及脂蛋白，共测量4小时。
将低回声斑块患者与高回声或中等回声斑块患者进行比较时，前者空腹和餐后血浆甘油三酯水平更高（P≤0.006），乳糜微粒残粒/极低密度脂蛋白胆固醇（P = 0.02）和甘油三酯（P≤0.004）更高，脂肪餐后0至4小时血浆甘油三酯曲线下面积更大，减去（AUCTG-TG oh）或未减去（AUCTG）空腹水平时均如此（P = 0.007和P = 0.003），体重指数更大（P = 0.03），且更年轻（P = 0.01）。多因素逻辑回归分析发现，在考虑年龄和体重指数后，空腹血浆和极低密度脂蛋白甘油三酯、餐后乳糜微粒残粒/极低密度脂蛋白甘油三酯、AUCTG-TG oh和AUCTG分别以4.1、3.8、3.0、2.7和4.3的比值比为低回声斑块的独立预测因素。
颈动脉低回声斑块与空腹或餐后富含甘油三酯的脂蛋白水平升高相关。
