前循环动脉粥样硬化性短暂性脑缺血发作与颈动脉斑块形成之间的关系

Relationship between the onset of atherosclerotic transient ischemic attack in anterior cycle and carotid plaque formation

目的 探讨前循环动脉粥样硬化性短暂性脑缺血发作（TIA）与颈动脉斑块形成之间的关系.方法 收集2010年1月至2012年5月诊断为前循环TIA并查颈彩超及头颅MRA证实患有颈动脉粥样硬化的患者87例（TIA组）,与同期住院经相同检查证实患有颈动脉粥样硬化的非TIA患者63例（nTIA组）相比较.分析组内及组间颈动脉的内膜中层厚度（IMT）、斑块的类型、Crouse积分和指数的差异.结果 组内比较发现：TIA组病灶侧颈动脉溃疡斑块和混合斑块比例增多（x2=12.045,P=0.017）;病灶侧颈动脉斑块的Crouse积分及指数均明显高于非病灶侧（Z=-2.494,P=0.013;Z=-3.378,P=0.001）;nTIA组左右两侧颈动脉的IMT、斑块类型、Crouse积分和指数差异均无统计学意义;组间比较：TIA组的SBP及DBP明显低于nTIA组[（155.95±17.67） mmHg vs （167.38±21.87） mmHg,P=0.001;（84.84±12.06）mmHg vs （90.90±11.56） mmHg,P=0.002],颈动脉斑块的Crouse评分及指数均明显高于nTIA组（Z=-5.020,P=0.000;Z=-5.018,P=0.000）.结论 颈动脉粥样硬化患者前循环TIA发作与颈动脉的粥样硬化程度及溃疡斑和混合斑块增多有关.

Objective To investigate the relationship between the onset of atherosclerotic transient ischemic attack （TIA） in anterior cycle and carotid plaque formation.Methods From Jan 2010 to May 2012,87 inpatients were diagnosed as TIA in anterior cycle and identified to have carotid atherosclerosis by carotid color ultrasound and head MRA scan,compared with 63 patients without TIA （nTIA） who were revealed by the same examinations in the same period of hospitalization.x2 test and mean comparison were used to analyze the difference of intima-media thickness （IMT）,plaque types,Crouse score and index of carotid artery within and between the 2 groups.Results Comparison within groups indicated that,in TIA group,more ulcer plux mixed plaques were detected in lesion side than in nonlesion side carotid artery （x2=12.045,P=0.017）; and comparing with non-lesion side carotid artery,there were higher Crouse scores （Z=-2.494,P=0.013） and index （Z=-3.378,P=0.001） of carotid plaque in lesion side carotid artery;in nTIA group,there were no significant differences of IMT,plaque types,Crouse score and index of carotid artery between the right and left sides.Comparison between groups demonstrated that the SBP and DBP[（155.95 ± 17.67） mmHg vs （167.38 ± 21.87） mmHg,P=0.001; （84.84 ± 12.06） mmHg vs （90.90 ± 11.56） mmHg,P=0.002] were significant lower and Crouse score （Z=-5.020,P=0.000） and index （Z=-5.018,P=0.000） of carotid plaque higher in TIA group than those in nTIA group.Conclusion The onset of TIA in anterior cycle in patients with carotid atherosclerosis is correlated with the degree of carotid atherosclerosis and increase of ulcer and mixed plaques.