颈内动脉形态异常与缺血性脑血管病及颈动脉粥样硬化的关系

Ultrasound diagnosis of morphological abnormalities of the internal carotid artery and relationship withischemic cerebrovascular disease and atherosclerosis

目的探讨颈内动脉形态异常的发生率及其与缺血性脑血管病、颈动脉粥样硬化的关系。方法联合应用高频和低频超声检查511例患者的双侧颈内动脉，对颈内动脉形态进行分型，并将其与临床资料对比，分析颈内动脉形态异常与缺血性脑血管病、颈动脉粥样硬化之间的关系。结果颈内动脉异常的发生率为50．1％，颈内动脉扭曲和环形扭结的发生率在脑梗死组与无症状组间差异有统计学意义（P〈o．001）。颈内动脉异常的发生率在斑块组、硬化组、正常组间差异有统计学意义（P〈0．001）。结论颈内动脉扭曲可能是脑梗死的危险因素之一。颈内动脉形态异常可能与颈动脉粥样硬化有关。

Objective To investigate the prevalence of morphological abnormalities of the internal carotid artery and relationship with ischemic cerebrovascular disease and carotid atherosclerosis. Methods A total of 511 consecutive patients were enrolled in this study and carotid abnormalities were classified according to the criteria of Wain and Metz by combining high^and low-frequency ultrasonography prospectively. Relationship of carotid abnormalities to ischemic cerebrovascular disease and carotid atherosclerosis were analyzed. Results Of the 511 cases, abnormalities of the internal carotid artery were found in 256（50.1 %）, the unilateral carotid abnormalities were found in 121 （23.7%）, and the bilateral in 135 （26.4%）, respectively. There was significantly difference in prevalence of kinking and coiling between ischemic stroke and asymptomatic group（ P 〈0. 001）, and prevalence of carotid abnormalities in the plaques and arteriosclerosis groups were statistically higher than the normal group（ P 〈0.001）. Conclusions The kinking and coiling of the internal carotid artery could be additive risk factors in the pathophysiology of an ischemic stroke, and carotid morphological abnormalities could be responsible for carotid atherosclerosis partly.