脑梗死与颈动脉粥样硬化及外周血管内皮功能的相关性

Correlative Studies of Cerebral Infarction,Carotid Atherosclerosis and Peripherial Vascular Endothelial Function

目的:探讨脑梗死与颈动脉粥样硬化及肱动脉内皮功能的相关性。方法:应用高频彩色多普勒超声显像仪检测20例脑梗死患者的双侧颈动脉内中膜厚度(IMT)、颈动脉粥样硬化斑块及肱动脉内皮依赖性和非内皮依赖性舒张功能,并与对照组进行比较,同时探讨颈动脉IMT与肱动脉内皮依赖性和非内皮依赖性舒张功能之间的相关性。结果:脑梗死组与对照组斑块发生率分别为90%及30%,前者显著多于后者(P<0.005),从斑块类型的构成来看,脑梗死组软斑构成比率明显高于对照组(P<0.01),扁平斑和硬斑构成比率明显低于对照组(P<0.005);脑梗死组与对照组比较,IMT显著增厚,FMD及NID显著减低(P<0.05);颈动脉IMT与肱动脉内皮依赖性和非内皮依赖性舒张功能呈显著负相关(r1=-0.523,P<0.02;r2=-0.570,P<0.01)。结论:颈动脉粥样硬化及外周血管内皮功能障碍与脑梗死的发生密切相关,可作为预测及评价脑梗死的重要指标之一。

Objective：To investigate the correlation between cerebral infarction, carotid atherosclerosis and endothelial function of brachial artery. Methods： Using ultrasonographic technique, carotid intima -media thickness （IMT）, carotid atherosclerotic plaque, brachial artery endothelium - dependent, flow - mediated （FMD） and endothelium - independent, nitroglycerin - induced vasodilation （NID） were measured in 20 patients with cerebral infarction and the control group. The correlation between carotid IMT and brachial artery dilation was analyzed. Results： the prevalence of carotic plaque was significantly higher in the patients than that in controls （ 90% vs 30%, P 〈0.005） ; the rate of soft plaques was significantly higher （P〈0.01）, the rotes of hard and flat plaques were significantly lower in the patients than those in controls （ P 〈0.005 ） respectively; IMT in the patients was significantly obeerved （P〈0.05）, FMD and NID were significantly decreased in the patients （P〈0.05） than these in the control group; a negative relationship was detected between the IMT and brachial artery dilation （ r1 = - 0. 523, P 〈 0.02 ; r2 = - 0.570, P 〈 0.01 ）. Conclusions： There is a close correlation between cerebral infarction, carotid atheroscleresis and endothelial function of brachial artery. Carotid artherosclerosis and brachial artery endothelial function can be used as the important indexes to predict and evaluate cerebral infarction.