颈动脉粥样硬化及斑块的性质、部位与缺血性卒中的关系:回顾性病例对照研究

目的 探讨颈动脉内膜-中膜厚度(intime-media thickness,IMT)、颈动脉粥样斑块性质、部位以及颈动脉狭窄程度与缺血性卒中的关系.方法 回顾性收集行彩色多普勒超声检查的首发急性缺血性卒中患者(缺血性卒中组)和同期门诊和住院的非缺血性卒中患者(对照组),对两组人口统计学资料、血管危险因素和颈动脉粥样硬...

The relationship between carotid atherosclerosis, characterization of plaque, position and ischemic stroke: a retrospective case-control study

Objective To investigate the relationship between the carotid intima-media thickness(IMT),the characterization of atherosclerotic plaque as well as the degree of carotid stenosis and ischemic stroke.Methods Tbe patients with first-ever acute ischemic stroke (ischemic stroke group)detected by color Doppler ultrasonogaphy and the outpatients and hospitalized patients without ischemic stroke in the same period(control groupl were collected retrospectively.The demogaphic data,vascular risk factors,and characterization of atherosclerotic plaque were compared between the two groups.Ischemic stroke group was divided into stroke subtype groups according to the TOAST classification.Their characteristics of carotid atherosclerosis were corapared.Restdt,A total of 200 patients with first-ever acute ischemic stroke and 200 patients without ischemic stroke were included in the study.The carotid IMT in the ischemic stroke group WaS sigaificantlv thicker than that in the control group(left side:1.04±0.22 mm vs.0.69±0.13 mm,t=7.34,P<0.01;right side:1.05 ±0.21 mm vs.0.71±0.16 mm,t=7.43,P<0.01).The proportions of the patients with moderate and severe stenosis were significantly higher(moderate stenosis:38% vs.14%,x1=7.64,P<0.01:SCVele stenosis:27% vs,6%,x2=7.93,P<0.01),and the proportion of patients with mild stenosis was no significant difference.The detection rate of carotid plaque in the ischemic stroke group was significantly higher than that in the control group(87.0% vs.31.5%,X2=7.01,P<0.01).The numbers of unstable plaque(tipid soft plaque,flat plaque,and mixed plaque)in the ischemic stroke group were 301(65.3%),and significantly mole than 65(31.7%)in the control group(x2=6.30,P<0.01).There was no significant difference in the distribution of carotid plaque between the two groups.The plaques were most common at the carotid artery bifurcation.Compared with those in other stroke subtypes.such as cardioembolism,small-vessel occlusion.stroke of other determined etiology,and stroke of undetermined etiology,the cm'otid IMT(left side:F=22.34,P<0.01;right side:F=21.41,P<0.01),and the proportion of Upid soft plaque(x2=7.93,P<0.01),carotid severe stenosis(x2=6.83,P<0.01),carotid occlusion(x2=14.00,P<0.01)in stroke patients with large-artery atherosclerosis were significantly incleased.Condusiom Carotid IMT,the numlbers of unstable Plaque as well as the degree of carotid stenosis were associated with the occurrence of isehemic stroke.