颈动脉颅外段狭窄与缺血性脑卒中早期预后关系的临床研究

目的分析颈动脉颅外段狭窄程度与缺血性脑卒中早期预后的关系。方法前瞻性纳入2010年3月至2011年2月衡阳市中心医院神经内科300例缺血性脑卒中患者，经头部CT或头部MRI证实为责任病灶。彩色多普勒超声检查结果按狭窄程度分为三组，A组未见狭窄及轻度狭窄（〈50％），B组中度狭窄（50％-69％），C组重度狭窄及完全闭塞（〉70％），并DSA证实狭窄血管跟责任病灶具有相关性。对缺血性脑卒中患者均进行内科综合治疗，于入院当天及第7、14．,21天给予评分。结果纳入了300例缺血性脑卒中患者，颈动脉颅外段狭窄发病率88％。A、B、C三组神经功能缺损评分比较有统计学意义（P〈0．05）。A组总有效率（96．O％）显著高于B组（68．8％）（P〈0．01）；而B组总有效率（68．8％）与C组（41．6％）相比差异亦有统计学意义（P〈0．05）；A组总有效率（96％）高于C组（41．6％）相比差异有统计学意义（P〈0．05），A、B、C三组之间有效率比较有统计学意义（P〈0．01）。结论缺血性脑卒中与颈动脉颅外段狭窄有关。颈动脉颅外段狭窄程度可能影响神经功能评分及缺血性脑卒中患者早期预后，狭窄越严重神经功能评分越高，早期顸后越差。

Clinical study of relationship between extracranial carotid artery stenosis and the prognosis of early stage cerebral ischemic stroke

【Objective】To analysis relationship betweem the degree of extracranial carotid artery stenosis and the the early stage prognosis of cerebral ischemic stroke.【Methods】 Prospective collected the cases of cerebral ischemic stroke which were in Neurology department from March,2010 to February,2011 of The Central Hospital of Hengyang City and the cases were examined by CT or MRI.The cases were divided into three groups by color doppler utrasound.Mild extracranial carotid artery stenosis into group A(<50%).Moderate extracranial carotid artery stenosis into group B(50%-69%).Serve extracranial carotid artery stenosis into group C(>70%).The cases were certificated that focuse of infection were related of extracranial carotid artery stenosis by DSA.The cases were be treated by combined therapy and were evaluated effect at the first day、the seventh day、the fouteenth day、the twenty-first day,Compared the effect.【Results】 Among the 300 cases of cerebral ischemic stroke,the rate of extracranial carotid artery stenosis is 88%.The scores of absence of neurological function of three groups marked with A、B and C is statistically significant(P<0.05).The absence of neurological function of three groups marked with A、B and C is statistically significant(P<0.05).Total effective rate(96.0%) of group A is significantly higher than that of group B(68.8%)(P <0.01);Group B,the total effective rate(68.8%) of which compared with that of group C(41.6%) is also statistically significant(P <0.05).Total effective rate(96.0%) of group A compared which in group C(41.6%),the difference statistically significant.(P<0.05).Between A、B and C,the difference of rate is statistically significant(P.<0.01).【Conclusion】 Cerebral ischemic stroke is related of extracranial carotid artery stenosis.The degree of extracranial carotid artery stenosis may affect nerve function score and prognosis.The more stenosis,the score is lower and the prognosis of early stage cerebral ischemic stroke is weaken.