颈动脉粥样硬化与不同类型脑梗死的关系

Relationship between carotid atherosclerosis and subtypes of cerebral infraction

目的探讨颈动脉粥样硬化与腔隙性脑梗死和非腔隙性脑梗死的关系。方法用彩色多普勒超声仪对45例腔隙性脑梗死者(腔梗组)、114例非腔隙性梗死者(非腔梗组)及39例非脑梗死者(对照组)进行颈动脉探查,观察颈动脉内膜-中层厚度(IMT)、粥样斑块的形态、数量并计算斑块积分。结果三组中非腔梗组颈动脉粥样硬化程度最严重,颈动脉斑块总体检出率(97%)最高,平均每例颈动脉斑块检出个数(2.50±1.63)最多(P<0.01),其次为腔梗组(P<0.05)。三组各型斑块构成比比较差异具有统计学意义(P<0.05)。非腔梗组中病灶侧不稳定斑块检出率高于非病灶侧(P<0.01)。结论颈动脉粥样硬化与脑梗死及其类型有关,利用超声技术检测颈动脉时各个指标要综合考虑,药物干预颈动脉粥样硬化应被重视。

Objective To investigate the relationship between carotid atherosclerosis and cerebral infraction subtypes, including lucunar infarct and lacal cerebral infarct. Methods 45 cases of LACI （lacunar infarct）, 114 cases of local cerebral infarct including partial anterior circulation infarct （PACI） and total anterior circulation infarct （TACI） and 39 cases of non-cerebration infraction （control group） were assessed by color doppler ultrasonography to detect the carotid intima-media thickness （IMT）, the numbers and morphology of carotid plaques. Scores of the plaques were calculated. Results Among the three groups, the severest grade of carotid sclerosis and the highest carotid plaque occurrence （97%） were detected in cases of local cerebral infarct. The plaque average in the group of local cerebral infarct was 2.50±1. 63 （the most）. The average in local cerebral infarct group was more than the other two groups （P 〈0.01）, next is the lacal cerebral infarct group （P 〈 0.01）. The carotid plaque,composition of the three groups was significantly different （P 〈 0.05）. In the group of local cerebral infartct,the occurrence of unstable carotid- plaque ipsilateral to cerebral infraction is higher than the others. Conclusions There is a relation between atherosclerosis and cerebral infraction and its subtypes. It should be synthetically caculated by using of ultrasonic detection to carotid. Pharmaceutical intervention should be attached importance to.