颈动脉粥样硬化与缺血性脑血管病及其危险因素的关系

RELATIONSHIP BETWEEN CAROTID ATHEROSCLEROSIS AND ISCHEMIC CEREBROVASCULAR EVENTS AND CARDIO-CEREBROVASCULAR RISK FACTORS

目的 :探讨彩色多普勒超声检测的颈动脉粥样硬化与缺血性脑血管病及其危险因素的关系。方法 :以10 1例脑血栓形成患者、2 9例TIA患者及 4 7例非缺血性心、脑血管疾病患者为研究对象 ,检测颈动脉粥样硬化程度及其危险因素。结果 :患者组与对照组间收缩压以及左、右颈总动脉内膜中层厚度 (IMT)差异均有统计学意义 ;脑血栓形成组与对照组间舒张压、空腹血糖、总胆固醇和甘油三酯差异均有统计学意义 :粥样硬化斑块常见于颈总动脉近分叉处 ,且易发生在双侧颈动脉及与脑部病灶同侧的颈动脉 ;年龄、收缩压及空腹血糖水平是颈动脉粥样硬化的独立危险因素。结论 :颈动脉粥样硬化与缺血性脑血管病的发病有关。

Objective:To assess whether extracranial carotid atherosclerosis measured by duplex ultrasonography is related to cardio-cerebrovascular risk factors and ischemic cerebrovascular events. Methods:We studied 101 cases of cerebral thrombosis, 29 cases of transient ischemic attack and 47 controls. Carotid atherosclerosis was assessed by 7.5-MHz duplex ultrasonography and various risk factors were evaluated. Results:Univariate analysis showed that the mean values of the common carotid artery intimal-medial wall and systolic blood pressure and the prevalence of carotid plaque were higher in cases than controls. Plaques is the most common near the bifurcation of the common carotid arteries and most patients had bilateral plaques or ipsilateral plaques to the ischemic event. The mean values of diastolic blood pressure,fast blood sugar, total cholesterol and triglyceride were higher in cases of cerebral thrombosis than controls. Case-control differences were all statistically significant. Multivariate analysis identified 3 significant variables that accounted for the carotid atherosclerosis.Conclusion:The present findings demonstrate that carotid atherosclerosis evaluated by ultrasonography is associated with ischemic cerebrovascular events.