颈动脉狭窄程度及颈动脉粥样硬化斑块性质、部位与脑梗死的相关性研究

Analysis of the relationship between carotid stenosis, carotid atherosclerotic plaque character, location and acute cerebral infarction

目的探讨颈动脉狭窄程度以及颈动脉粥样硬化斑块性质、部位与脑梗死的相关性。方法选取2013年4月~2014年1月急性脑梗死患者100例设为观察组,同时选取100例同期就诊非急性脑梗死患者设为对照组。所有患者行头颈动脉联合CTA检查,观察颈动脉狭窄程度以及斑块分布部位,并用斑块分析软件分析颈动脉狭窄程度及斑块性质。结果观察组颈动脉无狭窄,中、重度狭窄及闭塞较对照组增高（25.2%,28.0%,15.5%,11.1%比54.0%,15.2%,6.8%,3.0%）（P〈0.05）;观察组斑块检出率高于对照组（74.8%比46.0%,P〈0.01）;观察组不稳定斑块比例高于稳定斑块（83.9%比38.0%）（P〈0.05）,对照组稳定斑块比例高于不稳定斑块（62.0%比16.1%）（P〈0.05）;观察组混合斑块和软斑块发生率明显高于对照组（P〈0.01）,对照组纤维斑块及钙化斑块发生率明显高于观察组（P〈0.01）。结论颈动脉狭窄程度以及颈动脉粥样硬化斑块性质与急性脑梗死的发生具有明确的相关性,而颈动脉斑块部位与急性脑梗死发生无明显相关。

Objective To investigate the relationship between the degree of carotid stenosis as well as the character of atherosclerotic plaque and cerebral infarction. Methods From April 2013 to January 2014, totally 100 acute cerebral infarction patients were studied as the observation group. Meanwhile, 100 cases who were not acute cerebral infarction were selected as the control group. Carotid artery of all were examined by carotid artery CTA to observe the degree of carotid stenosis and to judge plaque characters as well as their location. Then they were measured by plaque analysis software. Results The number of no stenosis, mild and severe stenosis and occlusion in observation group was higher than those in control group （25.2%, 28.0%, 15.5%, 11.1% vs 54.0%, 15.2%, 6.8%, 3.0%, respectively） （P〈 0.05）;compared with control group, plaque detection rate was high （74.8% vs 46.0%） （P〈0.01）; in observation group, the occurrence of unstable plaque was higher than stable plaque （83.9% vs 38.0%） （P〈0.05）, in control group, the occurrence of stable plaque was higher than unstable plaque （62.0% vs 16.1%） （P〈0.05）; the incidence of mixed plaques and soft plaques in observation group was significantly higher than those of control group （P〈0.01）, the incidence of fibrous plaques and calcified plaques in control group was significantly higher than those of observation group （P〈0.01）. Conclusion The degree of carotid stenosis as well as the characters of atherosclerotic plaques are associated with acute cerebral infarction and there is no correlation between atherosclerotic plaques location and acute cerebral infarction.