缺血性脑卒中患者颈动脉粥样硬化及相关因素的临床研究

Carotid Atherosclerosis and Correlative Risk Factors in the Patients with Ischemic Stroke

目的探讨缺血性脑卒中患者颈动脉粥样硬化(CAS)及其相关因素。方法选择缺血性脑卒中患者360例,包括脑梗死和短暂性脑缺血发作(TIA)。应用彩色多普勒超声检查仪检测患者颈动脉颅外段的血管内-中膜厚度,根据检测结果将患者分为正常血管组(IMT≤0.9mm),硬化血管组(IMT>0.9mm),并询问病史,测量血压及检测相关生化指标。结果脑梗死与TIA的CAS发生率有显著差别。回归分析显示纤维蛋白原在CAS形成中的作用高于其它危险因素。结论脑梗死CAS的发生率高于TIA,血纤维蛋白原水平的升高是导致CAS最重要的独立危险因素。

Objective To investigate the carotid atherosclerosis and the related risk factors in the patients with ischemic cerebrovascular disease（ICVD）. Methods Carotid intima-media thickness （IMT） was measured by color Doppler uhrasonography in 360 cases with ICVD including cerebral infarction （CI） and transient ischemic attack （TIA）. The patients were divided into normal vessel group （IMT≤0.9 mm） and arterial sclerosis group （IMT 〉0.9 mm） according to the results of ultrasonography. The history was required. The blood pressure was measured and serum biochemical indicators were also detected. Results There was significant difference in the incidence of CAS between CI group and TIA group. The multiple factors logistic regression showed that the elevated fibrinogen played more important role for carotid atherosclerosis and carotid atherosclerotic plaque than traditional risk factors. Conclusions The prevalence of CAS in the patientswith CI is higher than that in the patients with TIA,and the elevated serum fibrinogen was the most important risk factor for the carotid atherosclerosis.