脑梗死患者颈动脉粥样硬化病变特征及其预测价值

目的:观察脑梗死患者颈动脉粥样硬化病变特征,评估颈动脉超声对脑梗死的预测价值。方法:对106例经CT、MRI证实的脑梗死患者的颈动脉颅外段进行彩色超声多普勒检查,观察颈动脉壁的病变性质和颈动脉管腔的狭窄率,并与对照组进行比较。结果:106例脑梗死患者中有78例(73.58%)颈动脉颅外段存在粥样硬化斑块,与对照组比较差异显著(P<0.01);粥样硬化斑块好发于颈总动脉分叉处,颈动脉狭窄程度、斑块的性质与脑梗死的发生密切相关。脑梗死组高血压病、糖尿病患者的发生率明显高于对照组(P<0.01)。结论:颈动脉粥样硬化与脑梗死有密切相关性,对合并高血压、糖尿病的高危人群常规行颈动脉超声检查可以早期预测脑梗死,防止颈动脉粥样硬化斑块形成对预防脑梗死的发生有非常重要的意义。

Characteristics and prognosticative value of carotid arteriosclerosis in patients with cerebral infarction

Objective: To observe the characteristics of carotid arteriosclerosis(CAS) in patients with cerebral infarction(CI),and to evaluate the prognosticative value of carotid ultrasound.Methods:Colour ultrasound Doppler examinations were performed in the segment outside skull of the carotid in 106 patients who had cerebral infarction confirmed by CT and MRI.The Pathological changes of the carotid wall and the narrowing rate of the carotid lumens were observed and compared with those in the control group.Results:Among these 106 patients,78 cases(73.58%) revealed various degrees of arteriosclerosis plaques at the segment outside skull of carotid,which was significant different compared with control group(P<0.01);Arteriosclerosis plaques were easily broken out at BIF,there was close relationship between stenosis rate of vascular and characteristics of plaques.The occurrence rates of patients with hypertension and diabetes mellitus were significantly higher in cerebral infarction group than those in control group(P<0.01).Conclusions:There is a significant correlation between carotid arteriosclerosis and cerebral infarction.Positive carotid artery ultrasound can predict CI early in patients with hypertension and diabetes mellitus.Prevention of carotid arteriosclerosis plague formation has important significance to avoid CI events.