颈动脉易损斑块与缺血性脑卒中复发的相关性研究

Correlation between carotid artery vulnerable plaques and recurrent ischemic cerebral stroke

目的对颈动脉斑块进行评价,分析斑块性质、形态及其危险因素与缺血性脑卒中复发的相关性。方法选择经头颅CT和(或)MRI确诊为缺血性脑卒中复发患者209例,应用CT血管造影联合彩色多普勒超声检查证实122例有颈动脉斑块,根据斑块性质分为易损斑块组86例,稳定斑块组36例,分析斑块性质、形态,观察发生缺血性脑血管事件相关因素,比较2组缺血性脑卒中复发的时间、分布及狭窄的关系,Cox风险比例模型分析缺血性脑卒中复发与颈动脉斑块等危险因素间的相关性。结果 209例患者中,颈动脉斑块122例,占58.4%。与稳定斑块组比较,易损斑块组年龄更高,高血压和冠心病的比例更多(P<0.05)。Cox回归分析显示,易损斑块与冠心病是缺血性脑卒中复发的危险因素。结论颈动脉斑块性质、形态和冠心病是缺血性脑卒中复发的危险因素。

Objective To assess the carotid artery plaques（CAP） and analyze the correlation of their nature, morphology and risk factors with recurrent ischemic cerebral stroke. Methods Of the 209 patients with recurrent ischemic cerebral stroke established by head CT and/or MRI in this study,122 were diagnosed with CAP by combined CT angiography and carotid artery ultra- sonography,86 were diagnosed with vulnerable CAP and 36 were diagnosed with stable CAP ac- cording to their nature. The nature and morphology of CAP were analyzed and related factors for ischemic cerebrovascular events were observed. Relation of recurrent time of vulnerable and non vulnerable ischemic ischemic cerebrovascular events with their distribution and stenosis was corn pared. Correlation between recurrent ischemic cerebrovascular events and risk factors for CAP was analyzed using the Cox risk model. Results CAP were detected in 122 patients（58.4%）. The age of patients with stable CAP was higher than that of those with vulnerable CAP. The propor- tion of hypertention and coronary heart disease was higher in patients with stable CAP than in those with vulnerable CAP（P〈0.05）. Cox regression analysis showed that the nature of CAP and coronary heart disease were the risk factors for recurrent ischemic cerebral stroke. Conclusion The nature and morphology of CAP and coronary heart disease are the risk factors for recurrent ischemic cerebral stroke.