腔隙性脑梗死发生、进展中颈动脉斑块特点分析

The Characteristics of Carotid Atherosclerotic Plaques in Patients with Lacunar Infarction at Initial and Progress States

目的:研究腔隙性脑梗死的发生、进展中颈动脉粥样硬化斑块的特点。方法:应用彩色多普勒超声仪对105例复发性腔隙性脑梗死患者(复发组)、83例初发性腔隙性脑梗死患者(初发组)和86例非腔隙性脑梗死患者(对照组)行颈动脉探查,观察颈动脉粥样硬化斑块的部位、数目、形态,并测量斑块处颈动脉内-中膜厚度(IMT),计算斑块积分(累加双侧颈动脉斑块最大厚度)。结果:3组斑块数目I、MT、斑块积分依次递减,差异有统计学意义(P<0.05);部位多见于颈总动脉分叉处且左侧多于右侧,以复发组尤为明显;复发组软斑、溃疡斑发生率明显高于另外2组(P<0.05)。结论:不稳定斑块明显增加腔隙性脑梗死复发风险,应定期监测斑块并积极治疗以减少复发。

Objective ：To study the features of carotid atherosclerotic plaques in patients with lacunar infarction at initial and progress states. Methods：Color Doppler, ultrasonography were used to detect the number,location and morphology of plaques on the walls of the carotid arteries in 105 patients with multiple lacunar infarction （recurrent group）,83 patients having the first stroke（initial group）and 86 controls. The IMT and scores of the plaques were calculated. Results： The number, IMT, integration of plaque decreased significantly in the initial and control groups when compared with the recurrent group （P〈0.05）. Further, the plaques often occur at BIF and the number on the left is more than that on the right. More importantly, more soft or ulcer plaques in the recurrent group were detected than in the initial and control groups （P〈0. 05）. Conclusion： Unstable carotid plaques evidently increase the risk for recurrence of lacunar infarction. It is suggested that the patients should receive regular ultrasonic examination and treatment to prevent the recurrence of lacunar infarction.