目的分析颈动脉粥样硬化斑块性质、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)水平与缺血性脑卒中临床发病率的相关性。方法 120例超声检查诊断为颈动脉斑块硬化患者,均经过超声造影检查确定颈动脉斑块性质,且根据斑块性质分为颈动脉斑块稳定组(A组,73例)与颈动脉斑块不稳定组(B组,47例)。两组患者均给予空腹肘静脉血检测血清中TNF-α、CRP含量,追踪随访6个月,统计入组患者缺血性脑卒中发病率。结果 A组与B组患者性别、年龄、体质量指数、血清总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白(LDL)水平比较,差异无统计学意义(P>0.05)。A组缺血性脑卒中发病5例,发病率6.85%;B组缺血性脑卒中发病9例,发病率19.15%;两组比较,差异有统计学意义(P<0.05)。依据患者血清中TNF-α、CRP水平分为升高组(C组)32例与正常组(D组)88例。C组缺血性脑卒中发病2例,发病率6.25%;D组发病6例,发病率6.82%;两组比较,差异无统计学意义(P>0.05)。颈动脉斑块不稳定及TNF-α、CRP水平升高患者21例(E组),颈动脉斑块稳定、TNF-α、CRP指标中任意一项异常患者99例(F组)。E组缺血性脑卒中发病8例,发病率38.10%;F组发病11例,发病率11.11%;两组比较,差异有统计学意义(P<0.05)。依据超声声像图表现将斑块分为Ⅰ、Ⅱ、Ⅲ级,Ⅰ级斑块46例,CRP(12.13±3.86)mg/L,TNF-α(23.16±4.91)pg/ml;Ⅱ级斑块34例,CRP(19.54±4.87)mg/L,TNF-α(29.03±4.38)pg/ml;Ⅲ级斑块40例,CRP(34.71±5.38)mg/L,TNF-α(43.61±5.82)pg/ml;3个等级间CRP与TNF-α水平比较,差异有统计学意义(P<0.05)。结论颈动脉粥样硬化斑块性质、TNF-α及CRP水平与缺血性脑卒中临床发病率高低关系密切,颈动脉斑块性质不稳定,TNF-α及CRP水平升高,患者缺血性脑卒中临床发病率明显增加,几项联合检测有助于评估近期缺血性脑卒中发病风险。 Objective To analyze the correlation between carotid atherosclerotic plaque, tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) and the clinical incidence of ischemic stroke. Methods One hundred and twenty cases of carotid plaques were diagnosed as carotid plaque sclerosis by ultrasound examination. The carotid plaque was confirmed by contrast-enhanced ultrasound and divided into three groups according to plaque characteristics: group A (n = 73) and carotid plaque Block instability group (B group, 47 cases). Both groups were given fasting cubital vein blood serum TNF-α, CRP levels were followed up for 6 months, the incidence of ischemic stroke was calculated. Results There was no significant difference in sex, age, body mass index, serum total cholesterol (TC), triglyceride (TG), and low density lipoprotein (LDL) between group A and group B (P> 0.05). A group of ischemic stroke in 5 cases, the incidence rate of 6.85%; B group of ischemic stroke in 9 cases, the incidence rate of 19.15%; two groups, the difference was statistically significant (P <0.05). According to the levels of TNF-α and CRP in patients’ serum, 32 cases were divided into elevated group (C group) and 88 normal group (D group). The incidence of ischemic stroke in group C was 2 cases, the incidence rate was 6.25%. The incidence of group D was 6 cases, the incidence was 6.82%. There was no significant difference between the two groups (P> 0.05). Carotid plaque instability and elevated levels of TNF-α, CRP in 21 patients (group E), stable carotid plaques, TNF-α, CRP indicators in any one of 99 patients (group F). The incidence of ischemic stroke in group E was 8 cases, the incidence rate was 38.10%. In group F, 11 cases were found, the incidence rate was 11.11%. There was significant difference between the two groups (P <0.05). According to the sonographic findings, the plaques were classified into Ⅰ, Ⅱ, Ⅲ grade, 46 grade Ⅰ plaques, 12.13 ± 3.86 mg / L CRP and 23.16 ± 4.91 pg / ml CRP There were 34 cases with CRP (19.54 ± 4.87) mg / L and TNF-α (29.03 ± 4.38) pg / ml, 40 cases with grade Ⅲ plaque, 34.71 ± 5.38 mg / L CRP and 43.61 ± 5.82 ) pg / ml. There was significant difference between the three levels of CRP and TNF-α levels (P <0.05). Conclusions The carotid atherosclerotic plaque, the level of TNF-α and CRP are closely related to the clinical incidence of ischemic stroke. The carotid artery plaque is unstable, the levels of TNF-α and CRP are elevated, and the ischemic The clinical incidence of stroke increased significantly, several joint tests can help assess the recent risk of ischemic stroke.