309例缺血性脑血管病患者颈动脉粥样硬化分析

The analysis of carotid atherosclerosis in 309 cases of different ischemic cerebral vascular diseases

目的探讨不同缺血性脑血管病（ICVD）与颈动脉粥样硬化（CAS）的关系。方法观察短暂性脑缺血发作（TIA）患者（TIA组）、腔隙性脑梗死（LI）患者（LI组）、脑梗死（CI）患者（CI组）共309例，分析三组ICVD患者的颈动脉超声构成、年龄、性别以及CAS斑块性质与位置的关系。结果（1）CI组颈动脉超声检出的CAS远较TIA组高（P〈0．05），但三组患者CAS程度比较，差异无统计学意义。（2）三组ICVD患者CAS检出率均与年龄呈正相关，LI组、CI组与年龄的关系较TIA组更为密切（P〈0．05）。超声检出CAS患者的硬化程度与年龄无相关性。（3）ICVD患者颈动脉硬斑检出率（93．34％）明显高于软斑和混合斑检出率（7．66％）。颈动脉分叉处（BIF）斑块总数及硬斑数也明显高于其他位置（P均〈0．05）。（4）性别与CAS无明显相关性。但60—69岁年龄段女性患者CAS检出率高于同年龄段男性患者（P〈0．05）。结论（1）CI组CAS检出率高于TIA组。（2）ICVD患者CAS检出率有年龄特征性，但CAS程度与年龄无相关性。（3）ICVD患者CAS斑块以硬斑为主，BIF是斑块高发部位。（4）总体上ICVD患者CAS检出率无性别差异，但60～69岁年龄段女性ICVD患者CAS检出率明显高于同年龄段男性患者。

Objective To discuss the relation between isehemic cerebral vascular diseases （ICVD） and carotid atherosclerosis（CAS）. Methods Three hundred and nine patients who had ICVD were investigated and classified into transient iscbemic attack （TIA） group,lacunar infarction （LI） group and cerebral infarction （CI） group. The carotid ultrasonicgraphy outcomes,age,gender and the property/locus of atheroselerotic spots were analyzed. Results （1）The incidence of CAS was significantly higher in CI group than that in TIA group （P〈 0.05）. But the CAS severity among the three groups was of no significance （P 〉 0.05 ）. （2）There was a positive correlation between the incidence of CAS and the increase of age among the three groups （P 〈 0.05 ）, but the severity of CAS had no relation with aging （P 〉 0.05 ）. （3）Solid CAS plaques happened more frequently among ICVD patients （93.34%）,whereas loose and composite CAS plaques was much lower（7.66% ）. The number of plaques near the bifurcating part of carotid was higher than that in other locus of carotid,so did the number of solid CAS plaques （P 〈 0.05）. （4）C, enerally, gender had no correlation with CAS. But the incidence of CAS was higher among female than among male in 60-69 years group（P〈 0.05 ）. Conclusions （ 1 ）The incidence of CAS is higher in CI group than that in TIA group. （2） Aging will affect the incidence of CAS among ICVD patients, but it has no relation with the severity of CAS. （3）Among ICVD patients, most of the CAS is solid plaques, and the bifurcating part of carotid is likely, to be the place where these plaques happen. （4）Generally, among ICVD patients, the incident of CAS has no gender difference. But in the group of 60-69 years old, it happens more frequently in female than in male.