脑梗死与颈动脉粥样斑块的相关性分析

目的探讨脑梗死与颈动脉粥样硬化斑块的相关性。方法采用彩色多普勒血流成像技术对217例脑梗死患者进行检测,观察其梗死侧和非梗死侧颈动脉内中膜厚度、斑块的部位、大小及其数目、动脉狭窄程度以及血流动力学改变等,并与124例对照组颈动脉粥样硬化斑块检出情况进行比较。结果脑梗死组患者的颈动脉粥样硬化斑块检出率为72.8%,显著高于对照组(25%,P<0.01)。颈动脉粥样硬化斑块多发生在脑梗死病灶的同侧,占85%,以颈总动脉分叉处居多,占58.4%。多因素Logistic回归分析显示斑块大小及其数量、峰值流速、搏动指数与脑梗死有明显的相关性(P<0.05),而颈动脉内中膜厚度、狭窄程度无明显差异(P>0.05)。结论脑梗死的发生与颈动脉粥样硬化斑块密切相关,防止斑块的形成对防止脑梗死的发生有非常重要的意义。

Evaluation of the correlation between cerebral infarctions and carotid arteriosclerosis plaques

Objective To evaluate the corre la tion between the cerebral stroke and carotid arteriosclerosis plaques. Methods Using the colour Doppler ultrasonography technique,the carotid intimal-medial thickness, the number and position of plaques,the extent of lume n narrowing and cerebral hemodynamic changes were measured at both the infarctio n and infarction-free sides in 217 patients with cerebral stroke,and compared with the controlled group. Results Of 217 patients,158(72.8% ) pateints showed presence of carotid arteriosclerosis plaques,the incidence was significant higher than control group(25%,P < 0.01).Most of them occurred at the same side of stroke focus(85%),especially in the bifurcation of common carotid artery(58.4%).The multifactorial logistic regression analysis: numbers of plaques,pulsatility index and peak velocity were significantly related to the stroke(P < 0.05 ),while the IMT and the extent of lumen narrowing were not(P > 0.05). Conclusion Stroke occurrence is cl osely correlated to the carotid arteriosclerotic plaques, dislodgment of plaques is the chief reason of stroke.Prevention of plaques fromation has important sig nificance to avoid stroke events.