浅谈颈动脉粥样硬化与进展性缺血性脑卒中的关系

Research on the Relationship between Carotid Atherosclerosis and Progressive Ischemic Stroke

目的探讨颈动脉粥样硬化与进展性缺血性脑卒中的关系。方法采用彩色多普勒超声仪对282例缺血性脑卒中患者的颈动脉进行评估,比较进展性缺血性脑卒中和非进展性缺血性脑卒中患者的颈动脉粥样硬化程度和特点。结果282例缺血性脑卒中患者中,有67例(23.8%)为进展性缺血性脑卒中;而重度颈动脉粥样硬化55例患者中,有25例(45.4%)发展为进展性卒中;重度颈动脉狭窄48例中,有24例(50.0%)发展为进展性卒中;在病理表现为溃疡斑的43例中,有23例(53.4%)发展为进展性卒中;无颈动脉粥样硬化或伴轻度颈动脉粥样硬化的缺血性脑卒中患者,仅9%发生进展性卒中。经Logistic回归分析发现,颈动脉粥样硬化程度、颈动脉狭窄程度和溃疡斑与进展性缺血性脑卒中发生呈正相关。结论颈动脉粥样硬化和狭窄程度及溃疡斑与进展性缺血性脑卒中的发生密切相关,可作为进展性缺血性脑卒中的预测指标。

Objective To study the relationship between carotid atherosclerosis and progressive ischemic stroke. Methods Doppler ultrasonography in 282 patients with acute ischemic stroke. And the characteristics of carotid atheroscherosis was compard to patients with or Without progressive ischemia stroke. Results Of all the 282 patients with ischemic stroke,67 patients（23.8%）were progressive during stroke acute period. 25（45.4%）of 55 patients with severe carotid atheroscherosis,24（50.0%）of 48 patients with carotid high-grade stenosis and 23（53.4%）of 43 patients with carotid ulcerated plaque. The frequency of progressive ischemic stroke in these patients was significantly higher than those patients without or with mild carotid atheroscherosis. The logistic regression analysis showed that the severity of carotid atheroscherosis,stenosis,ulcerated plaque were positively related to the progressive ischemic stroke.Conclusion There might be a positive relationshop between carotid atheroscherosis and ischemic stroke in evolytion.The severity of carotid atheroscherosis may be a risk predictor in stroke evolution.