缺血性脑卒中OCSP分型与颈动脉粥样硬化的关系

Relationship between OCSP classification and carotid artery atherosclerosis in ischemic stroke

目的观察缺血性脑卒中患者颈动脉粥样硬化的特点,探讨牛津郡社区卒中项目(OCSP)分型与颈动脉粥样硬化的关系。方法选取2010年2月至2011年11月在郑州大学第一附属医院神经内二科住院的急性缺血性脑卒中患者160例。所有患者根据临床症状进行OCSP分型,并行颈部血管彩超检查。了解颈动脉病变特点,分析OCSP分型与颈动脉粥样硬化的相关性。结果在160例缺血性脑卒中患者中,颈动脉斑块检出率为69.1%,颈动脉中度以上狭窄发生率为12.5%。部分及完全前循环梗死(PACI、TACI)组(A组)颈动脉斑块检出率为77.6%、不稳定斑块检出率为59.1%,高于后循环梗死(POCI)组(B组)和腔隙性脑梗死(LACI)组(C组),P<0.05。B组和C组间比较差异无统计学意义。结论与颈动脉粥样硬化性狭窄比较,颈动脉粥样硬化斑块的性质与脑梗死的发生关系更为密切。颈动脉粥样硬化斑块,尤其是不稳定斑块与PACI和TACI的形成关系密切。

Objective To observe the characteristics of ischemic stroke patients with carotid artery atherosclerosis, and to investigate the relations between stroke project（OCSP） of Oxfordshire community and carotid artery atherosclerosis. Methods During February in 2010 and November in 2011 in department of neurology of the central hospital of Jiaozuo coal group, 160 cases of patients with acute ischemic stroke admitted to hospital were selected. All of the patients were classified as OCSP classification according to clinical symptoms, and checked carotid artery duplex ultrasound. Under stand the characteristics of the carotid artery lesions, and analysis the relations between the OCSP classification and ca rotid artery atherosclerosis. Results In the case of 160 ischemic stroke patients, the rate of carotid artery plaque detec tion was 69. 1%, the incidence of moderate stenosis in carotid artery was 12. 5%. The rate of carotid artery plaque detec tion in Partial and total anterior circulation infarcts （PACI, TACI） group （group A） was 77. 6% , the rate of unstable plaque detection was 59. 1%, higher than posterior circulation infarcts （POCI） group （ group B ） and lacunar infarcts （LACI） group（group C）, P 〈 0. 05. There is no statistical significance between group B and group C. Conclusion Compared with carotid atherosclerotic stenosis, the nature of carotid atherosclerotic plaques is more closely relating to the occurrence of ischemic stroke. There is strong correlation between Carotid atherosclerotic plaques, especially the unstable plaques and the formation of PACI and TACI.