青岛地区缺血性脑血管病颅外颈动脉粥样硬化的调查

The Distribution of Arteriosclerosis of Extracranial Arteries Carotis in the Patients with Ischemic Cerebrovascular Disease in Qingdao

目的:分析本地缺血性脑血管病患者颅外颈动脉粥样硬化斑块的发生率,好发部位,斑块类型,两者之间的关系,了解本地区缺血性脑血管病患者颅外颈动脉粥样硬化的情况。方法:选择入院的135例急性缺血性脑血管病患者(包括脑梗塞患者90人和短暂性脑缺血发作患者45人为患病组)和同期门诊常规查体者30人(对照组),分别应用颈动脉彩超检测颅外颈动脉,检测其粥样硬化斑块发生率,好发部位,斑块类型。结果:患病组颅外颈动脉粥样硬化斑块的检出率(75.6%)与对照组(46.7%)比较,有显著性差异(P<0.01),脑梗塞(CI)患者颅外颈动脉粥样硬化斑块的检出率(76.7%)和短暂性脑缺血发作(TIA)患者(73.3%)比较无显著性差异(P>0.05)。患病组颅外颈动脉重度狭窄率(28.1%)与对照组(3.3%)比较有显著性差异(P<0.01),TIA患者颅外颈动脉重度狭窄率和正常对照组比较无显著性差异(P>0.05),CI患者与TIA患者颅外颈动脉重度狭窄率相比无统计学意义(P>0.05)。患病组与对照组斑块的好发部位均为颈总动脉分叉处(39.3%和35.0%),以硬斑(49.2%和65.5%)为主,两组不稳定斑块的比例(39.3%和20%)比较无显著性差异(p>0.05)。结论:①颅外颈动脉粥样硬化斑块是本地缺血性脑血管病人的病因之一。②本地缺血性脑血管病病人颅外颈动脉狭窄率较以往有增加。③颅外颈动脉粥样硬化斑块好发于颈总动脉分叉处,本地人群斑块可能以稳定性斑块为主。

Objective： To comprehend the condition of extracranial arteries carotis in the local patients with ischemic cerebrovascular disease, we analysed the incidence rate , predilection site and plague types of extracranial carotid arteriosclerotic plaque. Methods： To choose 135 admitted patients（ disease group）with acute ischemic cerebrovascular disease and 30 health examination persons （ control group） from out - patient clinic at the corresponding time period. To check the incidence rate , predilection site, plaque types of arteriosclerosis of arteries carotis by carotis color ultrasonography . Results： The detection rate （ 75.6% ） of ex- ternal carotid arteriosclerotic plaque in disease group was significantly higher than the one （46.7 % ） of control group （ p 〈0.01 ）. The detection rate（76.7% ） of extracranial carotid arteriosclerotic plaque in cerebral infarction disease group was similar to the one （ 73.3% ） of transient ischemia attach （ TIA ） group （ P 〉 0. 05 ）. The severe stenosis rate（28.1% ） of artery in disease group was significantly higher than the one（3.3% ） of control group（ P 〈0.01 ） , while the severe stenosis rate of TIA group was similar to the one of control group （ P 〉 0.05 ）, and also similar to the one of CI group （ P 〉 0.05 ）. The predilection site of plaque in disease group（39.3% ） is crotch of arteria carotis communis. , which was the same as control group（ 35. 0%）. The primary plaque type of disease group（49.2%） and control group （65.5%） was hard plaque. The compare for the instable plaque of disease group （ 39.3% ） and control group （ 20% ） had no significant difference （ P 〉 0.05 ）. Conclusion：①arteriosclerosis plaque of extracranial arteries carotis is one of the causes of ischemic cerebrovascular disease in the local patients. ②The local stenosis rate of extracranial carotid artery in patients with ischemic cerebrovascular disease now is higher than that in the past. ③The predilection site of extracranial carotid arteriosclerotic plaque is crotch of arteria carotis communis. The primary plaque type of local people may be stable plaque.