颈动脉狭窄患者微栓子的监测及治疗

Microembolic signal monitoring by tram-cranial Doppler in patients with carotid artery stenosis and its intervention therapy

目的应用经颅多普勒（TCD）超声诊断仪监测颈动脉狭窄患者的微栓子信号（MES），探讨干预治疗对颈动脉狭窄患者MES的影响。方法选择广西壮族自治区民族医院神经内科自2009年3月至2014年11月收治的158例颈动脉狭窄患者作为颈动脉狭窄组，另选取广西壮族自治区民族医院40岁以上在职及退休职工、无颈动脉狭窄者158例作为对照组，应用TCD超声诊断仪监测颈内动脉起始处MES，颈动脉狭窄患者口服阿司匹林肠溶片（100 mg/d）、阿托伐他汀钙胶囊（20 mg/d）10 d后再次应用TCD超声诊断仪监测MES，比较2组受试者及颈动脉狭窄患者治疗前后MES的阳性率。结果与对照组（1.9%）比较，颈动脉狭窄组患者MES阳性率（36.1%）增加，差异有统计学意义（P〈0.05）。与治疗前（36.1%）比较，颈动脉狭窄患者治疗后MES阳性率（7.6%）降低，差异有统计学意义（P〈0.05）。结论颈动脉狭窄患者脑血流中MES阳性率增高，通过药物治疗可以降低其阳性率。

Objective To investigate the microembolic signal （MES） in patients with carotid artery stenosis by transracial Doppler （TCD） diasonograph, and explore the influence of intervention treatment in MES of patients with carotid artery stenosis. Methods One hundred and fifty-eight patients with carotid artery stenosis, admitted to our hospital from March 2009 to November 2014, were enrolled as carotid artery stenosis group; and 158 workers from our hospital without carotid artery stenosis were used as control group. TCD was used to monitor the MES at the initiative internal carotid artery in the two groups; and then, 10 d after aspirin enteric coated tablets （100 mg/d） on platelet aggregation and torvastatin （20 mg/d） treatment, MES was monitored again; the MES positive rate between the two groups or in carotid artery stenosis group between before and after medication was compared. Results As compared with the control group （1.9%）, the carotid artery stenosis group （36.1%） had significantly increased MES positive rate （P〈0.05）. In the carotid artery stenosis group, MES positive rate before treatment （36.1%） was significantly higher than that after treatment （7.6%, P〈0,05）. Conclusion MES positive rate in the cerebral blood flow in patients with carotid artery stenosis is increased; treatment by drugs can reduce the microemboli positive rate