颈动脉粥样硬化与前循环缺血性脑血管病关系的探讨

Relationship between carotid atherosclerosis and ischemic cerebrovascular disease

目的探讨颈动脉粥样硬化与缺血性脑血管病的关系。方法以216例年龄在40～86岁的前循环缺血性恼血管病患者为研究对象,应用超声诊断仪检测双侧颈动脉颅外段,记录动脉内膜-中层厚度、斑块特征及狭窄率。结果缺血性脑血管病患者斑块检出率(169/216,78.2%)明显高于对照组(54/171,31.6%);不稳定性斑块在脑梗死组检出率较高(52/168,30.9%),在脑梗死各亚型中有所差异。颈动脉颅外段狭窄率较低(30/216,13.9%),但完全前循环梗死组中重度狭窄率较高(3/8,37.5%)。结论颈动脉粥样硬化与缺血性脑血管病关系密切,常规进行颈动脉颅外段彩色多普勒超声检测,对缺血性脑血管病的预防有不可忽视的指导作用。

Objective To study the correlation between carotid atherosclerosis and ischemic stroke. Methods Patients were re- cruited from the inpatient department of Xinjiang Autonomous Regional Corps Hospital, Chinese People＇s Armed Police Forces, aged from 40 to 86 years, of whom 216 had iscbemic cerebrovaseular disease （ICVD） in anterior cerebral blood circulation. Color Doppler ultrasonography was performed in extracranial carotid arteries （ ECCA ） in all patients. Recorded were intima - medial thickness of carotid artery, stigmata of carotid atherosclerotic plaques and frequency of ECCA stenosis. Results The detection rate of plaques in ECCA of 216 patients with ICVD（78.2% ） was higher than that in control subjects（31.6% ）. A higher detection rate of unstable plaques was shown in patients with cerebral infarction（30.9% ） ; unstable plaques were different in patients with cerebral infarction of various subtypes. Lower frequency of ECCA stenosis was observed in patients with ICVD（ 13.9% ） ; the detection rate of ECCA severe stenosis was higher in pa- tients with arterial occlusion of anterior cerebral blood circulation （37.5%）. Conclusions There is close correlation between carotid ath- erosclerosis and ICVD. Color Dopplar Uhrasonography of ECCA has a significant guiding role in all patients with ICVD.