老年腔隙性脑梗死的发生及与颈动脉粥样硬化斑块的关系研究

Relationship between Occurrence of Lacunar Infarction and Carotid Atherosclerotic Plaque in Elderly Patients

目的观察老年腔隙性脑梗死发生的情况及颈动脉粥样硬化斑块发生的特点。方法选取2012年3月—2013年9月经头颅CT或/及MRI检查,诊断为腔隙性脑梗死合并颈动脉粥样硬化斑块的老年患者(≥65岁)268例作为观察组,207例单纯腔隙性脑梗死老年患者为对照组,对比两组疾病特点及观察组颈动脉粥样硬化斑块的分布部位、性质及相应血管狭窄情况。结果观察组高血压病、糖尿病、血脂紊乱、冠心病患病率明显增高(P<0.01);斑块发生部位以颈动脉窦部较多见、且左侧较右侧多发;硬斑较多,其中,颈内动脉虹吸部硬斑较多,软斑以颈动脉窦部最多;轻度狭窄的发生率高于中度狭窄及重度狭窄。结论老年腔隙性脑梗死发生中,动脉硬化斑块及动脉狭窄起重要作用,控制高血压、糖尿病、血脂紊乱对控制老年颈动脉硬化斑块发生、发展,防止腔隙性脑梗死起积极作用。

Objective To observe the occurrence characteristics between lacunar infarction and carotid athero- sclerotic plaque in elderly patients. Methods During March 2012 and September 2013, after CT or/and MRI examina- tions, 268 elderly patients （ ≥65 years old） were chosen as observation group, who were diagnosed as having lacunar in- farction complicated by carotid atherosclerotic plaque; 207 elderly patients were chosen as control group, who were diag- nosed as having lacunar infarction. Disease characteristics of the two groups were compared, and distribution positions, nature and corresponding angiostegnosis of carotid atherosclerotic plaques in the observation group were analyzed. Results Prevalence rates of hypertension, diabetes, blood lipid disorders and coronary heart disease in observation group were significantly higher （P 〈 0. 01 ） ; the main distribution position was in carotid sinus, and the spots existed mainly on the left side ; the most spots were hard, and the hard spots mostly existed in internal carotid artery of siphon ; soft spots mostly existed in carotid sinus. The incidence rate of mild stenosis was higher than those of moderate and severe stenosis. Con- clusion Atherosclerotic plaque and arterial stenosis play an important role in elderly patients with lacunar infarction, The occurrence and development of elderly patients with carotid atherosclerosis plaque or the lacunar infarction can be prevented by controlling hypertension, diabetes, blood lipid disorders.