脑梗死患者颈部动脉杂音与颈动脉狭窄的关系

Relationship between cervical artery murmur and carotid artery stenosis in patients with cerebral infarction

目的研究脑梗死患者颈部动脉杂音与颈动脉狭窄的关系。方法对245例脑梗死患者进行颈部动脉听诊与血管造影检查。根据颈部动脉杂音部位分为锁骨上窝杂音、颈前弥漫杂音及颈前局限杂音,并根据杂音强度分为1～5级。对颈部动脉听诊及血管造影结果进行分析、比较。结果听诊发现本组145例(59.2%)患者有颈部动脉杂音,其中锁骨上窝杂音62例、颈前弥漫杂音44例、颈前局限杂音39例,100例患者(40.8%)无杂音;1～5级杂音分别有28例、26例39例、34例及18例。有颈部动脉杂音的患者颈动脉狭窄的发生率(64.1%,93例)显著高于无杂音患者(49%,49例)(P<0.05)。颈前局限杂音患者颈动脉狭窄及重度狭窄的发生率显著高于锁骨上窝杂音及颈前弥漫杂音杂音患者(均P<0.01)。颈部动脉杂音分级越高,颈动脉重度狭窄率越高(P<0.05)。结论有颈部动脉杂音的脑梗死患者颈动脉狭窄的发生率高,尤以颈前局限性杂音患者显著;杂音强度与颈动脉狭窄的程度有关。

Objective To explore the relationship between cervical artery murmur and carotid artery stenosis in patients with cerebral infarction （CI）. Methods Two hundred and forty-five CI patients received examinations of cervical artery auscultation and angiography. According to the position of the cervical artery murmur, which were divided into the supraclavicular fossa, cervical anterior diffuse murmur and cervical anterior limited murmur. According to the strength of the murmur, which were divided into 1 to 5 grades. The results of carotid artery auscultation and angiography were compared and analyzed. Results By the auscultation, the 145 cases （59.2%） had cervical artery murmur, including 62 cases with supraclavicular fossa murmur, 44 cases with cervical anterior diffuse murmur, 39 cases with cervical anterior limited murmur. And the 100 cases （40.8%）had no cervical artery murmur. The incidence of carotid stenosis in patients with cervical artery murmur was 64.1% （93 cases） , which was significant higher than patients without cervical anterior murmur （49% , 49 cases ） （P 〈 0. 05 ）. The incidences of carotid stenosis and serious stenosis in patients with cervical anterior limited murmur were significant higher than those in patients with supraclavieular fossa and cervical anterior diffuse murmur （ all P 〈 0. 01 ）. The higher the grade of cervical anterior murmur, the higher was incidence of carotid serious stenosis （ P 〈 0. 05 ）. Conclusions The incidence of carotid stenosis is increased in CI patients with carotid artery murmur, especially higher in patients with cervical anterior limited murmur. The grade of carotid artery murmur is related with the degree of carotid stenosis.