伴有颈动脉斑块的急性前循环脑梗死患者的微栓子研究

Study of microemboli in acute anterior circulation cerebral infarction patients with carotid atherosclerotic plaques

目的探讨颈动脉斑块、微栓子和急性前循环脑梗死的关系。方法选择住院的急性前循环脑梗死患者65例,经颈动脉超声检查分为伴有颈动脉斑块组45例和不伴有颈动脉斑块组20例,2组均行微栓子监测。结果伴有颈动脉斑块组与不伴有颈动脉斑块组吸烟、高血压病、糖尿病、高脂血症相比无明显差异(P>0.05);伴有颈动脉斑块患者的微栓子阳性率为38%,不伴有颈动脉斑块患者为13%,2组相比有明显差异(P<0.05);软斑组微栓子阳性率为45%,硬斑组微栓子阳性率为18%,2组相比有明显差异(P<0.05)。结论急性前循环脑梗死患者多有颈动脉斑块,软斑块是微栓子的主要来源,微栓子是急性脑梗死发病的重要危险因素,对二者早期干预是防治脑卒中的重要措施之一。

Objective To study the relationship between microemboli and carotid atherosclerotic plaques in acute anterior circulation cerebral infarction patients. Methods The microemboli and carotid atherosclerotic plaques in 65 patients were detected by color ultrasonography, and they were divided into plaque group （n = 45） and non- plaque group （n = 20）. Results No significant difference was found in smoking, hypertension, diabetes and hyperlipidema between the 2 groups（P〈0. 05）. The positive rate of microemboli was 38% in plaque group and 13% in non- plaque group, and there was a significant difference between the 2 groups（P〈 0. 05）. The positive rate of microemboli was 45~ in soft plaque group and 18% in hard plaque group, and there was a significant difference between the 2 groups（P〈0. 05）. Conclusion Carotid atherosclerotic plaques occur in most of acute anterior circulation cerebral infarction patients. Soft plaque is the main source of micro- emboli which is an important risk factor for the onset of acute cerebral infarction. The early intervention in soft plaque and microemboli is one of the important measures for the prevention and treatment of stroke.