TIA患者脑动脉微栓子与颈动脉粥样硬化斑块的关系

The relationship of cerebral microembolic signal and carotid artery plaque in patients with transient ischemic attack

目的探讨短暂性脑缺血发作(TIA)患者脑动脉微栓子与颈动脉粥样硬化斑块的关系。方法 95例TIA患者依据颈动脉超声检测分为颈动脉无斑块组(39例)和斑块组(56例),后者再分为不稳定斑块亚组(24例)和稳定斑块亚组(32例);对所有患者应用经颅多普勒仪进行脑动脉微栓子监测,比较各组间微栓子阳性率并进行统计学分析。结果①脑动脉微栓子阳性率在颈动脉斑块组(44.6%)高于无斑块组(17.9%),两者比较差异有统计学意义(P<0.05);②在不稳定斑块亚组(66.7%)显著高于稳定斑块亚组(28.1%),两者比较差异有统计学意义(P<0.05)。结论伴有颈动脉粥样硬化斑块的TIA患者脑血流中微栓子阳性率高,不稳定斑块更易脱落形成微栓子。针对微栓子的治疗可能是预防或减少TIA发生的重要方法。

eTo explore the relationship of carotid artery plaque and microembolic signal （MES） in patients with tran- sient ischemic attack （TIA）. Methods According tO the results of carotid artery ultrasonic examination, 95 TIA patients were dividedinto carotid artery noplaque group （39 cases） and carotid artery plaque group （56 cases）, the latter included unsteady plaque subgroup （24 cases） and steady plaque subgroup （32 cases）. The cerebral artery MES of all the patients were monitored by transcranial Doppler （TCD）. The positive rate of MES was compared among the groups. Results The positive rate of MES in carotid artery plaque group （44.6%） was higher than that in no -plaque group （17.9%） , and which in the unsteady plaque subgroup （66.7%） was signif- icantly higher than that in steady plaque subgroup （28.1% ） （ P 〈 0.05 ）. Conclusion The positive rate of MES in cerebral artery blood flow in TIA patients with carotid atherosclerotic plaque is higher. The unsteady plaque is much easier to generate microembolism. Treatment on MES may be an important measure to prevent or reduce TIA.