颈动脉颅外段狭窄和斑块对脑梗死患者病情进展的影响

目的探讨脑梗死病情进展与颈动脉颅外段狭窄和斑块的关系,为早期采取积极的预防和治疗,降低脑梗死患者病变加重造成的致残率及致死率。方法对我院脑病科2015—2016年收治的92例脑梗死患者以进展性标准分为病情进展组(58例)和病情无进展组(34例),均行高分辨率磁共振成像(HRMRI)检查,通过2组患者HRMRI检测结果对比,揭示斑块的形态学特征及管腔狭窄程度与脑梗死病变加重有无关系。结果2组间斑块内出血、脂质核坏死的发生率无显著性差异(P0.05),病情进展组纤维帽较薄或破裂的发生率则明显高于病情无进展组(P0.05);轻度动脉狭窄率和中度动脉狭窄率组间比较无差异(P0.05),病情进展组重度颈动脉管腔狭窄率高于病情无进展组(P0.05)。结论颈动脉重度狭窄和斑块不稳定性是脑梗死病变加重的重要病理基础,可作为进展性脑梗死的预测指标之一。

The impact of extracranial stenosis and plaque of carotid artery on the progression of cerebral infarction

Objective To investigate the relationship between progression of cerebral infarction and extracranial stenosis and plaque in the carotid artery,thereby taking the early prevention and treatment to reduce the morbidity and mortality of the patients with cerebral infarction.Methods 92 patients with cerebral infarction in our hospital from 2015 to 2016 were enrolled in this stud-y.58 patients were assigned to the progression group and 34 patients to the non-progression group.All patients underwent high-resolution magnetic resonance imaging (HRMRI)examination.The results of HRMRI were compared between the two groups. The correlation between the morphological features of the plaque and the number of stenosis with the severity of cerebral infarction was analyzed.Results There was no significant difference in the incidence of intracranial hemorrhage and lipid nuclear necrosis be-tween the two groups (P > 0.05 ).The incidence of fibrous cap thinning or rupture was significantly higher in the progression group than that in the non-progression group (P <0.05).There was no significant difference between the two groups in the rate of mild arterial stenosis and moderate arterial stenosis (P >0.05).The rate of severe arterial stenosis was significantly higher in the progression group than that in the progression-free group (P <0.05).Conclusion Severe stenosis and plaque instability of carotid artery is an important pathological basis of aggravating cerebral infarction,which can be used as one of the predictors of progres-sive cerebral infarction.