Associations among cerebral microbleeds, cerebral large-artery diseases and endothelial function

Background Endothelial dysfunction is not only an early stage of atherosclerosis,but also involved in the pathogenesis of cerebral small-vessel diseases.Patients with cerebral microbleeds （CMBs） may have arteriolosclerosis as well as systemic atherosclerosis.However,little is known about the associations among CMBs,atherosclerosis of cerebral large arteries,and endothelial function.Our study aimed to investigate the relationships among them.Methods This was a cross-sectional study.Ninety patients hospitalized in Peking University First Hospital with acute ischemic stroke were enrolled consecutively between November 1,2007 and January 31,2008.All subjects underwent transcranial Doppler and carotid color duplex ultrasonography to record the intima-media thickness （IMT） of common carotid artery,carotid plaque,and cerebral artery stenosis.Brain magnetic resonance imaging （MRI） routine sequences and gradient recall-echo T2＊-weighted imaging were performed to count CMBs with clinical data blindness.Endothelial function was evaluated using flow-mediated dilation （FMD） and nitroglycerin-mediated dilation （NMD） of the brachial artery.FMD and NMD were examined by an experienced vascular sonographer using a high-resolution ultrasound.Results Thirty cases （33.3%） had CMBs with counts ranging from 1 to 30.Both FMD （（9.9＆#177;4.8）% vs.（15.2＆#177;7.4）%,P=0.001） and NMD （（13.7＆#177;6.1）% vs.（19.0＆#177;7.4）%,P=0.001） were significantly decreased in CMB-positive patients than in CMB-negative patients.No significant relationships were demonstrated between CMBs and intracranial and/or extracranial artery stenosis.The frequencies of CMBs in patients with IMT≥1.0 mm,carotid plaque,and extracranial artery stenosis were 37.5%,39.4%,and 47.6% respectively,with no significant difference,but much higher than in patients with IMT 〈1.0 mm （5%,P 〈0.05）.In Logistic regression analysis,impaired FMD （OR=5.783,95% CI 1.652-6.718,P=0.007） and high pulse pressure （OR=6.228,95     

Immune Vasculitis Induced Atherosclerosis

Summary： The relationship between immune vasculitis and atherosclerosis was studied. The experimental model of weanling rabbits for immune vasculitis was reproduced by intravenous injection of 10% bovine serum albumin. There were 6 groups： group A, 25 weanling rabbits with immune vasculitis subject to coronary arteriography; group B, 10 normal mature rabbits subject to coronary arteriography; group C, 10 weanling rabbits subject to coronary arteriography, group D, 8 weanling rabbits with vasculitis and cholesterol diet; group E, 8 weanling rabbits receiving single cholesterol diet; group F： 8 weanling rabbits receiving basic diet. Four weeks later, coronary arteriography was performed in groups A, B and C. The rabbits in groups D, E and F were sacrificed for the study of pathological changes in the coronary artery after 12 weeks. The results showed that the dilatation of coronary artery occurred in 6 rabbits of group A, but in groups B and C, no dilatation of coronary artery appeared. In comparison with group E, more severe atherosclerosis occurred in group D, showing the thickened plaque, fibrous sclerosis and atherosclerotic lesion. Percentage of plaques covering aortic intima, incidence of atherosclerosis of small coronary arteries and degree of stenosis of coronary arteries were significantly higher in group D than in group E （P〈0.01）. No atherosclerosis changes were found in group F. It was concluded that in the acute phase, the serum immune vasculitis can induce the dilatation of coronary artery of some weanling rabbits, and aggravate the formation of atherosclerosis in rabbits fed with cholesterol diet. Immune vasculitis is a new risk factor of atherosclerosis and ischemic heart disease.     

Relationship between Carotid Atherosclerosis and Cerebral Infarction

Objective To study the relationship between carotid atherosclerosis and cerebral infarction （CI）. Methods Between November 2008 and March 2009,147 CI patients （CI group） and 48 patients with non-cerebrovascular diseases （control group） were enrolled from inpatients of Neurology Department of our hospital. The diagnostic criterion of thickened carotid intima was set as 1.0 mm≤intima-media thickness （IMT） 1.5 mm and that of carotid plaque was as IMT≥1.5 mm. Carotid atherosclerosis was divided into three levels： normal intima,thickened intima,and plaque formation. The color Doppler ultrasonography data of carotid arteries in all patients were analyzed and the severity of carotid atherosclerosis was compared between the two groups. Results In the CI group,36 （24.5%） patients had normal carotid intima,22 （15.0%） had thickened carotid intima,and 89 （60.5%） had carotid plaque. In the control group,22 （45.8%） patients had normal carotid intima,4 （8.3%） had thickened carotid intima,and 22 （45.8%） had carotid plaque. The severity of carotid atherosclerosis in the CI group was higher than that in the control group （P=0.022）. There was significant difference in the constitution of carotid plaque between the two groups （P=0.001）; the CI group mainly had the soft plaque （55/89,61.8%）,whereas the control group mainly had the hard plaque （17/22,77.3%）. The first three common locations of carotid plaque in both groups were carotid bifurcation （CI group： 73.7%; control group： 64.1%）,common carotid artery （CI group： 20.4%; control group： 25.6%）,and internal carotid artery （CI group： 5.9%; control group： 10.3%）. The location of carotid plaque between the two groups was not significantly different （P=0.438）. There was no difference in the carotid inner diameter or resistance index between the two groups （P0.05）. Conclusions Carotid atherosclerosis is to some extent able to reveal the atherosclerotic condition of cerebral arteries and act as an important predictor for the risk of CI. The color Doppler ultrasonography of carotid arteries can provide a convenient way for the prevention and treatment of CI.     

Prevalence of CMV in arterial walls and leukocytes in patients with athero sclerosis

Objective To investigate the association of cylomegalovirus with atherosclerosis.Methods The presence of cylomegalovirus (CMV) nucleic acids was demonstrated in carotid and coronary arteries of patients with and without atherosclerosis by polymerase chain reaction (PCR).CMV was detected by PCR in the blood of patients with an d without atherosclerosis.Results 83.3%-86.7% of the samples obtained from atherosclerotic patient arterial wall s were shown to contain viral nucleic acids (CMV), CMV could be found among 6.7 % of patients’ arterial wall without atherosclerosis, significant difference can be found between them (P<0.01).In blood CMV could be found in 42.4% of patients with atherosclerosis, in the control group, only 3% of samples had CMV, P<0.01.Conclusion CMV plays an important role in the pathologic process of the atherosclerosis and the atherosclerotic cerebral infarction.     

Expression of CD151 in Human Atherosclerotic Artery and Its Implication

To investigate the expression of CD151 in human atherosclerosed artery and explore its clinical implications, Western blot and immunohistochemical techniques were used to determine the protein expression of CD151 in arterial tissues with atherosclerosis taken from 36 patients, including 26 cases who received bypass operation for peripheral artery atherosclerosis and 6 cases who died from coronary heart disease. The expression of CD151 in normal artery tissues from 15 healthy organ donators were also measured to serve as control. The results showed that expression of CD151 protein in atherosclerotic arteries was significantly higher than that in normal artery. In atherosclerotic arteries, CD151 expression was localized in vascular smooth muscle cells （VSMCs） in all tunica media and in partial subintima, while in normal artery, sparse expression was found in tunica media near adventitia. It is concluded that high CD151 protein expression in artery is associated with atherosclerosis and CD151 plays an important role in the atherosclerosis related to VSMC. The expression of CD151 in human atherosclerotic artery depends on the extent of atherosclerotic damage, it＇s independent of risk factors.     

Research on hemodynamics of cerebral arteriovenous malformation by Doppler ultrasound.

Combined extracranial and transcranial Doppler (TCD) instruments were used to study the hemodynamics of 20 patients with cerebral arteriovenous malformation (AVM) proved angiographically. It was discovered that the flow velocities in AVM-feeding arteries and their proximal arteries were increased; the increase of flow velocities in feeding arteries close to AVM was more remarkable than that in feeding-arteries proximal to extracranial internal carotid artery far from AVM; pulsating indexes of AVM-feeding arteries were decreased; increase of flow velocities in AVM-feeding arteries was related to the decrease of pulsating index; the flow velocities of nontapering feeding arteries were faster than those of tapering arteries; the greater the size of AVM, the faster the velocity in feeding artery; and the flow velocities and pulsating indexes of AVM-feeding arteries were gradually recovered to normal 3-5 weeks after resection of AVM. It is believed that increase of flow velocity in AVM-feeding artery is associated with distention and decreased resistance of flow in AVM-feeding artery. TCD combined with CT scans are helpful to the diagnosis of AVM. Combination of TCD and cerebral angiography (CAG) to evaluate comprehensively the preoperative hemodynamics of AVM and to monitor postoperative changes is helpful to detecting cerebral steal due to steal leakage in circle of Willis and preventing the hazardous postoperative complications caused by pressure breakthrough of normal perfusion.

     

INTRAVASCULAR ULTRASOUND IMAGING OF ANGIOGRAPHICALLY "SILENT" LEFT MAIN CORONARY ARTERY ATHEROSCLEROSIS

Patients with left main coronary artery (LMCA) atherosclerosis have a poor prognosis compared with lesions in the other coronaries. Because of the methodological problems. LMCA atherosclerotic lesions are not frequently detected by coronary angiography. The purpose of the study was to reveal the existence of LMCA disease in patients with normal coronary arteries by using intravascular ultrasound imaging. Ninety-seven patients with angiographically normal coronary arteries were examined with a 3.5 F or 4.8 F. 20 MHz intravascular ultrasound catheter. The vessel, lumen and plaque areas were determined and percent area and diameter stenosis were calculated. Plaque formation with or without calcific deposits identified by ultrasound accoustic shadowing were regarded as signs of atherosclerosis.     

Pre-clinical atherosclerosis evaluated by carotid artery intima- media thickness and the risk factors in children

Background Atherosclerosis as a cardiovascular disease was found to begin even in the fetal period. However, information about risk factors of pre-clinical atherosclerosis in childhood has been limited. Hence, this study was aimed to find out the risk factors of atherosclerosis by measuring the carotid artery intima-media thickness in children. High resolution B-mode ultrasound used to examine the carotid artery inUma-media thickness was demonstrated to be useful in finding the early carotid structural changes. Methods The study included 79 children who were divided into two groups according to their ages： group I consisted of 42 children with ages from 5 to 9 years and group II consisted of 37 children with ages from 10 to 18 years, Among them, 23 had a positive family history for risk, such as hypertension, obesity or dyslipidemia. Blood samples were collected and total cholesterol, triglycerides, high density lipoprotein and low density lipoprotein were assayed. The carotid artery intima-media thickness was measured by ultrasound. Comparisons were done between the two groups using Student＇s t tests and Chi-square analysis. Body mass index, blood pressure, levels of lipids, family history and the carotid artery intima-media thickness were calculated by conditional logistic regression analysis. Results Compared with the children without a positive family history, the incidence of the increased carotid artery intima-media thickness was significantly high （X^2=4.364, P〈0.05）. There were no statistically significant differences between left and right carotid arteries in carotid artery intima-media thickness （P〉0.05）. In this study, diastolic blood pressure and the atherosclerosis index were suggested to be the risk factors to the thickened carotid artery intima-media thickness. In group I the diastolic blood pressure＇s odds radio was 1.187 （P=-0.035） and the atheroscterosis index odds radio was 37.165 （P=-0.001）; in group II the diastolic blood pressure＇s odds radio was 1.371 （P=0.009） and the atherosclerosis index odds radio was 30.724 （P=-0.015）. Conclusion The diastolic blood pressure and atherosclerosis index were the risk factors in pre-clinical arthrosclerosis. Regularly monitoring the high-risk children for the development and progression of vascular lesion would be of great value in avoiding and preventing cardiovascular disease.     

Fifty-eight cases of ocular ischemic diseases caused by carotid artery stenosis

Background The blood supply to the eye comes from the retinal central vascular system of the ophthalmic artery and the ciliary vascular system. The ophthalmic artery stems from the ipsilateral internal carotid artery. If occlusion or stenosis occurs in the carotid artery, the blood perfusion to the ophthalmic artery becomes insufficient, leading to signs and symptoms of anterior and posterior ocular ischemia. The objective of this study was to evaluate the clinical characteristics and risk factors of ocular ischemic diseases caused by carotid artery stenosis. Methods This study was a retrospective review of 145 patients with carotid artery stenosis. Fifty-eight patients who had symptoms of ocular ischemic disease caused by carotid artery stenosis formed group A and the other 87 patients who only had carotid artery stenosis formed group B. We analyzed the causes and course of disease, and relative risk factors, by comparing the two groups. Results The degree of carotid artery stenosis in group A was higher than that in group B. And group A had a greater decrease of ophthalmic artery flow. Male, hypertension, hyperlipidemia, and smoking were significantly related to carotid artery stenosis. Amaurosis fugax was the most common ocular symptom in group A. The ocular ischemic diseases mainly included ischemic optic neuropathy, central/branch retinal artery occlusion, ophthalmoplegia externa, and ocular ischemic syndrome. Conclusions Carotid artery stenosis correlates with ocular ischemic diseases. Ophthalmologists must observe for ocular symptoms, which were the onset symptoms in some patients.     

Cerebral artery reconstruction in the treatment of large and giant intracranial aneurysms.

From 1978 to 1988, 14 giant intracranial aneurysms(more than 2.4 cm in diameter) and one large aneurysm (1.5cm in diameter) were treated by extracranial/intracranial(EC/IC) bypass or cerebral artery reconstruction. Of theaneurysms, 10 were located at the intracavernous carotid ar-tery (CCA). One of the 10 anourysms was posttraumatic andlocated at both the carotid-ophthalmic artery segment and thebifurcation of the internal carotid artery (ICA). Three wereseen at the middle cerebral artery (MCA) trunk.Theaneurysms were demonstrated by angiography and CTscanning. They were treated with trapping of the aneurysm andsuperficial temporal artery (STA)/middle cerebral artery(STA-MCA) bypass with/without a graft (6 cases), cervicalICA ligation and STA-MCA bypass with / without a graft (6)aneurysm excision with an end-to-end anastomosis of theMCA and a STA-MCA bypass with a graft (1), proximal     

老年原发性高血压合并无症状性脑梗死的脑血管评估

目的：探讨老年原发性高血压静止性脑梗死与颅内-外动脉狭窄的关系。方法：对86例老年原发性高血压合并静止性脑梗死患者的数字减影血管造影（DSA）和彩色多普勒超声（Duplex）检查资料进行分析。计算颅内-外动脉狭窄率及斑块未检出率，并对DSA和Duplex检查进行比较。结果：86例患者颈动脉颅外段斑块检出率高于正常对照组（62．79％，24．00％，P〈0．01）。86例患者中，单纯颅外动脉、颅内动脉及颅内-外动脉多发性狭窄或闭塞发生率分别为43．02％（37／86）、16．82％（14／86）和27．91％（24／86）。颅外动脉狭窄或闭塞发生率高于颅内动脉（70．93％，44．19％，P〈0．001）。Duplex对颈动脉颅外段狭窄检查结果与DSA差异不显著（P〉0．05）。结论：在老年原发性高血压合并静止性脑梗死患者中，颈动脉颅外段狭窄有较高的患病率。对老年原发性高血压患者定期进行颈动脉Duplex超声检查，可早期发现颈动脉颅外段狭窄并采取相应措施，对预防缺血性脑血管病有重要意义。     

急性脑梗死患者颅内外动脉狭窄的分布规律及危险因素分析

目的:探讨急性脑梗死患者颅内外动脉狭窄的分布规律及相关的常见危险因素。方法:对63例急性脑梗死患者发病48 h内均行脑CT血管造影术,并对狭窄组和非狭窄组患者的年龄、性别、高血压病史、糖尿病病史、冠心病病史、既往卒中史、TIA史、吸烟史、TC、TG、HDL-C、LDL-C、纤维蛋白原等水平进行比较。运用Logistic回归分析上述与颅内外动脉狭窄有关的危险因素。结果:所有患者中,40例(63.5%)有颅内外动脉狭窄,其中单纯颅内动脉狭窄15例(37.5%),单纯颅外动脉狭窄12例(30%),颅内外动脉同时狭窄13例(32.5%)。同时存在2条以上动脉狭窄23例(57.5%)。Logistic回归分析显示吸烟、年龄、糖尿病、高血压、纤维蛋白原是颅内外动脉狭窄的独立危险因素。结论:急性脑梗死患者颅内动脉狭窄的发生率高于颅外动脉狭窄的发生率,存在多条动脉狭窄的患者较多;吸烟、年龄、糖尿病、高血压、纤维蛋白原与颅内外动脉狭窄有关。     

脑梗死患者的脑血管造影分析

目的探讨脑梗死患者脑血管造影(DSA)的特点。方法经CT、MR I确诊为脑梗死并行DSA检查的70例患者的临床资料,分析脑动脉狭窄或闭塞情况。结果70例患者中,17例患者造影阴性,53例存在脑动脉狭窄或闭塞。53例造影阳性患者中,44例存在责任血管,其中单纯颅外动脉狭窄12例,单纯颅内动脉狭窄24例,颅内、外动脉联合狭窄8例;轻-中度狭窄11例,重度狭窄-闭塞33例,两者之间侧支循环的发生率有统计学意义(P<0.01)。结论脑梗死患者所有脑动脉狭窄和责任血管中,颅内病变明显多于颅外病变,最常累及的病变部位是大脑中动脉(MCA)、颈内动脉(ICA)起始部和椎动脉(VA)开口,最常见的侧支循环是W illis环和软膜血管,严重的脑动脉狭窄更易引起侧支循环。     

血浆同型半胱氨酸水平与脑动脉狭窄程度的相关性

目的探讨血浆同型半胱氨酸水平与脑大动脉狭窄程度的相关性。方法选择行全脑数字减影血管造影术(DSA)检查的急性缺血性脑卒中患者269例。根据DSA显示动脉狭窄是否≥50%为依据,分为2组:狭窄组(150例)患者颅内、外脑大动脉至少1支血管狭窄率≥50%;对照组(119例)患者无狭窄或狭窄<50%。检测两组血浆同型半胱氨酸(Hcy)水平,按Hcy值分4个水平(≤11.8μmol/L、11.9-14.1μmol/L、14.2-17.1μmol/L、≥17.2μmol/L)观察血管狭窄≥50%的发生率。进行多因素logistic回归分析。结果狭窄组血浆Hcy水平明显高于对照组。随着血浆Hcy水平升高,脑大动脉粥样硬化狭窄≥50%的发生率逐渐增加(分别为48.6%、53.7%、53.8%、67.2%)。血浆Hcy水平升高是脑大动脉粥样硬化狭窄的独立危险因素(OR=1.071,95%CI:1.004-1.142,P=0.036)。结论 Hcy升高与脑大动脉狭窄程度密切相关,降低血浆Hcy水平与控制其它危险因素同样重要。     

老年缺血性脑血管病患者脑动脉狭窄部位分布特点及危险因素检测

目的探讨缺血性脑血管病(ICVD)患者脑动脉狭窄(CAS)的分布特点及危险因素。方法采用彩色多普勒超声和磁共振血管成像(MRA)对ICVD患者200例进行检测,根据CAS部位分为单独颅内动脉狭窄(A组)、单独颅外动脉狭窄(B组)、颅内外动脉狭窄(C组)3组,比较3组间动脉硬化危险因素的差异。结果 200例ICVD患者中CAS患者72例(36.0%),其中A组30例(41.7%),B组15例(20.8%),C组27例(37.5%) A组年龄明显低于B、C组(P<0.05)。C组纤维蛋白原(Fib)显著高于B组(P<0.05)结论ICVD患者CAS的分布具有年龄差异,Fib是颅内外并发狭窄的危险因素之一。     

脑分水岭梗死与颅内外血管狭窄的相关性分析

目的　探讨脑分水岭梗死 (CWI)与颅内外血管狭窄的相关性。方法　对 6 88例脑梗死患者行常规头颅CT和 (或 )MRI检查以明确梗死部位 ,其中分水岭梗死 139例 ,非分水岭梗死 5 49例。应用经颅多普勒(TCD)检测颅内血管 ,双功能彩色多普勒检测颅外血管 ,如有重度血管狭窄 (狭窄 80 %以上 )作脑血管造影检查(DSA)进一步证实。结果　 139例脑分水岭梗死患者中 ,有 5 1例颈内动脉闭塞 ,44例重度颈内动脉狭窄 ,6 0例合并颅内血管多发狭窄 ;非脑分水岭区梗死患者 5 49例中 ,2 0例颈内动脉闭塞 ,17例颈内动脉重度狭窄 ,134例颅内血管多发狭窄。将两组资料进行卡方检验 ,有显著性差异。结论　颈内动脉严重狭窄、闭塞、颅内血管的多发狭窄是脑分水岭梗死的主要发病原因     

缺血性脑卒中患者颅外段颈动脉狭窄的临床特点及危险因素

目的分析缺血性脑卒中患者颅外段颈动脉狭窄的临床特点,并探讨其相关危险因素。方法前瞻性纳入370例首发缺血性脑卒中患者,采用彩色多普勒超声诊断仪对双侧颈动脉进行检查,按超声检测结果分狭窄组和非狭窄组,进行相关危险因素分析。结果370例中颅外段颈动脉狭窄者124例(33.51%),其中狭窄≥50%者56例(15.14%),7例为颈内动脉闭塞(1.89%);97例大动脉粥样硬化型脑卒中患者中颅外段颈动脉狭窄28例(28.87%),颅内血管狭窄58例(59.79%)。多因素分析显示,缺血性脑卒中患者颅外段颈动脉狭窄与高龄、高脂血症及高纤维蛋白原血症呈正相关(P<0.05),而与性别、高血压、糖尿病、吸烟及饮酒无相关性(P>0.05)。结论缺血性脑卒中患者颅外段颈动脉狭窄的发病率较低,但有增高的趋势。高龄、高脂血症及纤维蛋白原升高可能是缺血性脑卒中患者颅外颈动脉狭窄的危险因素。     

缺血性脑血管病脑动脉狭窄的分布特征

目的探讨缺血性脑血管病患者脑动脉狭窄的分布规律。方法回顾性分析2012年1～9月中国中医科学院西苑医院治疗的缺血性脑血管病患者234例的螺旋CT血管造影资料。根据脑内有无梗死分为无脑梗死组66例及脑梗死组128例,分析前、后循环及颅内、外动脉病变分布特征。结果①234例患者中,194例存在脑血管病变。脑梗死组颅内、外病变并存（71.9%）明显多于无脑梗死组（25.8%）,无脑梗死组单纯颅外病变（60.6%）多于脑梗死组（20.3%）,差异有高度统计学意义（P〈0.01）。②194例血管病变中,共检出血管病变数1005处,其中颅外动脉病变636处（63.3%）多于颅内动脉病变369处（36.7%）。脑梗死组颅内血管病变数（40.0%）多于无脑梗死组（23.5%）,差异有高度统计学意义（P〈0.01）。③194例血管病变中,共有953支血管存在不同程度的狭窄,中度以上狭窄动脉数脑梗死组（36.8%）多于无脑梗死组（14.8%）,差异有高度统计学意义（P〈0.01）;中度以上狭窄动脉数脑梗死组前循环（42.8%）多于后循环（29.2%）,差异有高度统计学意义（P〈0.01）。在194例血管病变中,中度以上狭窄动脉数颅内（45.4%）多于颅外（25.0%）,差异有高度统计学意义（P〈0.01）。结论缺血性脑血管病变发生率颅外多于颅内,但狭窄程度颅内重于颅外;脑梗死患者前循环动脉狭窄程度比后循环严重。     

缺血性脑血管病患者脑动脉狭窄的分布特征及其危险因素分析

目的 探讨缺血性脑血管病患者脑动脉粥样硬化性狭窄闭塞病变的分布特点;分析并比较颅内、外动脉粥样硬化性狭窄的危险因素.方法 对583例连续行全脑血管造影检查的缺血性脑血管病患者的临床和血管造影资料进行分析.结果 56例血管造影未见异常.527例存在脑动脉狭窄或闭塞病变,其中24.3%(128例)仅有颅外动脉病变,36.8%(194例)仅有颅内动脉病变,38.9%(205例)颅内外病变并存,颅内动脉病变的发生率(75.6%,399例)高于颅外动脉(63.2%,333例).脑梗死患者和颈动脉系统短暂脑缺血发作患者,均是颅内病变多于颅外病变,但椎基底系统短暂脑缺血发作则以颅外病变为主(P<0.01).青年(≤40岁)患者大部分为单纯颅内动脉病变(75.5%),主要累及大脑中动脉;而中年(41～60岁)及老年(≥61岁)患者以颅内外病变并存的比例最高(39.4%和48.0%,P<0.001),病变最好发于颈内动脉起始部.高血压、糖尿病、血脂异常是颅内动脉病变的独立危险因素,而年龄、冠心病、糖尿病、血脂异常是颅外病变的独立危险因素.颅外病变者的年龄和冠心病患病率显著高于颅内病变者.结论 总体上颅内动脉粥样硬化性狭窄闭塞病变的发生率高于颅外动脉,但颅外病变并不少见,且常表现为颅内外病变并存.不同亚组的患者动脉病变的分布不同.颅外病变者的冠心病患病率、年龄高于颅内病变者.     

颈内动脉狭窄与脑梗死关系的研究(附76例报告)

目的探讨高血压病、2型糖尿病患者颅外段颈内动脉(ICA)狭窄与脑梗死的关系.方法选择年龄＞60岁的住院患者76例,分为三组:高血压病组26例,2型糖尿病组25例,高血压病合并2型糖尿病组25例;均进行颈部螺旋CT和头颅CT、MRI检查.结果高血压病合并糖尿病组患者的ICA重度狭窄(19例)较单纯高血压病组(10例)及单纯糖尿病组(10例)严重(P＜0.05);三组患者中ICA重度以上狭窄者,脑梗死的发生率明显高于轻-中度狭窄者(100.0%:24.3%)(P＜0.05).结论老年人高血压与糖尿病合并存在时,可加速动脉粥样硬化的发展;颅外段颈内动脉狭窄程度与脑梗死的发生有密切关系.