脑梗死及短暂性脑缺血发作患者颈动脉彩超检查的临床意义

SIGNIFICANCE OF CEREBRAL CAROTID ARTERY ULTRASONOGRAPHY IN PATIENTS WITH ISCHEMIC ATTACK AND CEREBRAL INFARCTION

目的探讨应用高频超声观察脑梗死患者颈动脉粥样硬化斑块的临床意义。方法应用高频探头检查颈动脉，观察内中膜厚度，有无斑块形成，斑块的大小、性质及部位，管腔狭窄程度，测量血流参数等。结果500例脑梗死患者中，检出1支或多支血管粥样硬化斑块形成者315例（颈外动脉斑块不计算在内），占总人数的63．12％，由于粥样硬化斑块导致管腔局部狭窄（每例以1支最窄血管计）〈50％者76例，占24．11％，50％～60％5例，占1．42％，〉70％179例，占5．67％，其余55例未见明显狭窄，占17％。短暂性脑缺血发作（TIA）100例，60例异常，表现为不同程度的颈总动脉和／或颈内、颈外动脉狭窄；有50例同时显示颈内动脉系统的血管狭窄表现，2例未见异常，总异常率83％（50／60）。结论颈动脉超声检查中对颈动脉超声狭窄、动脉斑块形成、内中膜增厚明显增加的评估，对缺血性脑血管疾病的检出与监测具有重要意义。

Objective To explore the clinical significance of high frequency ultrasound in observing carotid atherosclerotic plaque in patients with cerebral infarction Methods High frequency ultrasound with a high frequency probe was performed to inspecting carotid atherosclerosis plaque in patients with cerebral infarc- tion in this study, then the intima- media thickness, plaque formation and size, nature and position of plaque were observed, and the stenosis severity of lumen, blood flow parameters were measured. Results Totally 315 of 500 cases o{ cerebral infarction were detected one or more vascular atheroselerotic plaque for- mation （ external carotid artery plaque doesn＇t count ）, the total number of 63.12%, luminal stenosis 50 % due to atherosclerotie plaque accounted for 24. 1i ~ （76 cases）, 50 - 60 ~ in 5cases, accounting for 1. 42%, ~70% in 179 cases, accounted for 5.67~. In 100 TIA cases, 60 of them were abnormal, showed different degrees of carotid artery or / and internal carotid, external carotid artery stenosis; 50 of 60 also showed internal carotid artery stenosis vascular system, abnormal rate was 83~. Only 2 cases were nor- mal,Conclusion Carotid ultrasonography can assess arterial stenosis, plaque formation, intima- media thickness increased, it plays an important action on detection and monitoring of ischemic cerebrovaseular disease.