颈动脉内膜增厚/斑块形成与脑梗死的相关性

Correlation of carotid artery intima thickening/plaque formation and cerebral infarction

目的探讨颈动脉内膜增厚／斑块形成不同阶段在脑梗死形成中的作用。方法将2008年2月至2011年2月我科收治的286例缺血性脑血管病患者，经头颅磁共振确定有无新发脑梗死而分为脑梗死组（203例）和非脑梗死组（83例），根据超声检查颈动脉内膜中膜厚度分为正常组（49例）、颈动脉内膜增厚组（39例）和颈动脉斑块形成组（198例）；首先观察颈动脉内膜增厚，斑块形成在脑梗死组与非脑梗死组中的分布差异，并进而研究其与脑梗死的相关性。结果脑梗死组具有更高的斑块发生率，非脑梗死组有更多的正常内膜存在，而内膜增厚在两者之间比例相近；以正常内膜组作为参照，Logistic回归分析显示OR（95％CI）在内膜增厚组为2．344（0．971，5．656）、斑块组为3．442（1．797～6．593）。结论颈动脉内膜增厚／斑块形成不同阶段与脑梗死的发生具有不同的致病作用。

Objective To investigate the role of carotid artery intima thickening/plaque formation in the de- velopment of cerebral infarction. Methods Two hundred and eighty-six patients of isehemie cerebral vascular dis- ease in our department from Feb. 2008 to Feb. 2011 were divided into cerebral infarction group （n=203） and non-cere- bral infarction group （n=83） according to MRI. The patients were also divided into three groups based on carotid ar- tery intima-media thickness （IMT） examined by B-mode ultrasound： the normal group （n=49）, intima thickening group （n=39） and plaque formation group （n=198）. The distribution of carotid artery intima thickening/plaque forma- tion was observed in the cerebral infarction group and non-cerebral infarction group, and then the relationship between arotid artery intima thickening/plaque formation and cerebral infarction were studied. Results The cerebral infarc- tion group was found with higher incidence of plaque formation, and the non-cerebral infarction group was found with higher incidence of normal intima. The incidence of carotid artery intima thickening was similar in the two groups. Compared to the normal group, the OR （95% CI） was 2.344 （0.971-5.656） in intima thickening group and 3.442 （1.797-6.593） in the plaque formation group. Conclusions The impact of arotid artery intima thickening/plaque for- mation on cerebral infarction are dissimilar in different stages.