颈动脉粥样硬化与脑梗死复发的关系探讨

目的 探讨颈动脉粥样硬化的临床意义及与脑梗死复发的关系。方法 采用彩色多普勒超声对312例脑梗死患者的颈动脉进行检测，并随访12－18个月，比较脑梗死复发和无复发患者颈动脉粥样硬化的特征。结果 312例脑梗死患者在随访期有61例复发，动脉粥样硬化性血栓性脑梗死患者的复发率明显高于腔隙性脑梗死患者，且多为同侧复发；重度颈动脉粥样硬化57例，复发26例；重度颈动脉狭窄48例，复发25例；溃疡斑42例，复发23例，其复发率明显高于无颈动脉粥样硬化或伴轻度颈动脉粥样硬化的脑梗死患者。经Logistic回归分析发现，颈动脉粥样硬化的严重程度、狭窄程度以及溃疡斑与脑梗死的复发成正相关。结论 颈动脉粥样硬化与脑梗死的复发密切相关，颈动脉粥样硬化的严重程度是脑梗死复发的危险因素，可作为脑梗死复发的预测指标。

The relationship between carotid atherosclerosis and cerebral infarction recurrence

Objective To study the clinical significance of carotid atherosclerosis and the relationship between carotid atherosclerosis and cerebral infarction recurrence.Methods Carotid atherosclerosis was assessed using doppler ultrasongraphy in 312 patients with cerebral infarction, the duration of following up was 12 to 18 months,and the characteristics of carotid atherosclersis was compared to patients with or without recurrence cerebral infarction.Results Of the 312 patients with cerebral infarction, 61 patients suffered from new cerebral infarction during following up period, the recurrence rate in patients with atherothrombotic brain infarction was higher than those with lacunar infarction, and the cerebral infarction recurrence usually occurred in the same side of initial stroke of the 57 patients with severe carotid atherosclerosis, 26 patients had a sufference of new infarction, of the 48 patients with high grade stenosis, 25 had a sufference of new cerebral infarction, of the 42 patients with ulcerated plaque, 23 had sufference of new cerebral infarction,showing a recurrence rate significantly higher than those patients with non carotid atherosclerosis or those with mild carotid atherosclerosis. The logistic regression analysis showed that the levels of carotid atheroslerosis , stenosis and ulcerated plaque were positively related to the cerebral infarction recurrence.Conclusions There is a positively relationship between carotid atherosclerosis and cerebral infarction recuurrence, and the level of carotid atherosclerosis is a risk factor of cerebral infarction recurrence.It serves as a risk marker of cerebral infarction recurrence.