缺血性脑血管病患者的颈动脉粥样硬化临床研究

Clinical Researchment of Carotid Atherosclerosis in Patients with Ischemic Cerebrovascular Disease

目的分析国人颈动脉粥样硬化(CAS)斑块发病特征及与缺血性脑血管病的相关性。方法以2006年6月至2009年6月在安徽铜陵有色职工总医院神经内科住院的164例急性缺血性脑血管病患者为研究对象,应用超声诊断仪检测双侧颈动脉,评价粥样硬化斑块的发病部位、形态、大小与数目,采用非条件多元逻辑回归分析颈动脉粥样硬化的危险因素及与缺血性脑血管病的关系。结果85.9%(141/164)患者存在不同程度颈动脉粥样硬化。颈动脉粥样硬化病变特点以斑块多见(134/164,81.7%),中重度狭窄发生率较低(26/164,15.8%);颈动脉斑块以颈总动脉分叉处最多见(69/134,51.4%)。斑块发生率及颅外段颈动脉狭窄程度与脑血管病危险因素有明显相关性。结论缺血性脑血管疾病患者颈动脉粥样硬化病变可能以斑块居多,颈动脉粥样硬化与缺血性脑血管病有关。

Objective To investigate the stigmata of carotid atherosclerotic plaques in Chinese patients,and evaluate the relationship between ischemic cerebrovascular disease（ICVD） and carotid artery atherosclerosis.Methods 164 subjects with acute ICVD enrolled in the neurologic department of tongling worker’s hospital from June 2006 to June 2009 underwent carotid artery duplex ultrasonography to evaluate the localization,morphology,size and number of atherosclerotic lesion.Logistic regression was performed to analyze the risk factors of carotid atherosclerosis and the relationship between the oues and ICVD.Results 85.9%（141/164）of all the patients had a varying degree of carotid atherosclerosis,in which the occurrence of the atherosclerotic plaques （81.7%,134/164）higher than that of stenosis of the extracranial carotid （15.8%,26/164）.Carotid atherosclerotic plaques were most commonly seen in the bifurcations of the common carotid artery （51.4%,69/134）.The severity of stenosis of the extracranial carotid and the formation of the atherosclerotic plaques were significantly correlated to the risk factors of cerebrovascular disease.Conclusions Atherosclerotic plaques are dominant characteristics of carotid atherosclerosis in the patients with ICVD.There is a positive correlation between carotid atherosclerosis and ICVD.