颈动脉粥样硬化与脑梗死发生的关系

The relationship between carotid atherosclerosis and cerebral infarction occurrence

目的:探讨颈动脉粥样硬化与脑梗死发生的关系。方法:采用彩色多普勒超声对700例短暂性脑缺血发作(TIA)患者的颈动脉进行检测,比较脑梗死发生者和未发生者颈动脉粥样硬化的特征。结果:700例TIA患者在随访期有186例发生脑梗死,存在颈动脉粥样硬化的TIA患者脑梗死发生率明显高于无颈动脉粥样硬化患者,且多为同侧发生;重度颈动脉粥样硬化93例,发生脑梗死65例;重度颈动脉狭窄82例,发生脑梗死64例;溃疡斑73例,发生脑梗死58例,其脑梗死发生率明显高于无颈动脉粥样硬化或伴轻度颈动脉粥样硬化的TIA患者。经Logistic回归分析发现,颈动脉粥样硬化的严重程度、狭窄程度以及溃疡斑与脑梗死的发生呈正相关。结论:颈动脉粥样硬化与脑梗死的发生密切相关,颈动脉粥样硬化的严重程度是脑梗死发生的危险因素,可作为脑梗死发生的预测指标。

Objective： To study the relationship between carotid atherosclerosis and cerebral infarction occurrence.Methods： Carotid atherosderosis was assessed using doppler ultrasongraphy in 700 patients with transient ischemic attack（TIA）, and the characteristics of carotid atherosclerosis was compared between patients with or without cerebral infarction.Results： Of the 700 patients with TIA,186 patients suffered from cerebral infarction during following-up period,the occurrence rate in patients with atherothrombotic TIA was higher than those without atherothrombotic TIA,and the cerebral infarction usually occurred in the same side of initial stroke;of the 93 patients with severe carotid atherosclerosis,65 patients had a sufference of cerebral infarction;of the 82 patients with high-grade stenosis,64 had a sufference of cerebral infarction; of the 73 patients with ulcerated plaque,58 had a sufference of cerebral infarction,showing occurrence rate significantly higher than those patients with non carotid atherosclerosis or those with mild carotid atherosclerosis.The logistic regression analysis showed that the levels of carotid atherosclerosis,stenosis and ulcerated plaque were positive related to the cerebral infarction occurrence.Conclusion： There is a positive relationship between carotid atherosclerosis and cerebral infarction occurrence,and the level of canotid atherosclerosis is a risk factor of cerebral infarction occurrence.It serves as a risk marker of cerebral infarction occurrence.