颈动脉粥样硬化斑块与急性脑梗死患者神经功能缺损的关系研究

Clinical research on the relationship between carotid atherosclerotic plaques and neurological deficits in patients with acute cerebral infarction

目的探讨急性脑梗死患者颈动脉粥样硬化斑块与神经功能缺损评分之间的关系。方法选择2009年8月至2015年12月期间在本院急诊科和神经内科住院的急性脑梗死患者732例,根据美国国立卫生院卒中评分(NIHSS评分)将患者分为轻症组(n=415)和中重症组(n=317);根据颈动脉彩色多普勒超声仪检查结果将患者分为有斑块组(n=475)和无斑块组(n=257)。比较轻症组与中重症组及有斑块组与无斑块组患者的年龄、性别、血压、血脂、血糖差异,分析轻症组和中重症组颈动脉斑块发生率的差异。结果有斑块组患者年龄、收缩压、低密度脂蛋白、空腹血糖均高于无斑块组,组间比较差异有显著性(P<0.05),NIHSS评分中重症组颈动脉斑块发生率明显大于轻症组,组间比较差异有显著性(P>0.05)。结论颈动脉斑块发生与脑梗死患者神经功能缺损程度NIHSS评分有密切关系。

Objective To investigate the relationship between carotid atherosclerosis plaque and neurological impairment score in patients with acute cerebral infarction（CI）. Method Patients with CI were selected from August 2009 to December 2015 in Department of Emergency and Department of Neurology Ruijin Hospital, total 732 CI patients were divided into mild group（n=415） and moderate severe group（n=317） according to the National Institutes of Health Stroke score（NIHSS score）, meanwhile, all patients were divided into carotid plaque group（n=475） and non-carotid plaque group（n=257） according to the results of carotid artery color Doppler ultrasound examination.The differences of age, sex, blood pressure, blood lipid and blood glucose among the subgroups were compared, and the difference of the incidence of carotid plaque between the mild and moderate severe group was analyzed. Result Significant differences were found in age, systolic blood pressure, lower density lipoprotein and blood glucose between the carotid plaque and non-carotid plaque groups of CI patients（P〈0.05）, while the incidence of carotid plaque in moderate severe group were significantly higher than the mild group（P〉0.05）.Conclusion The incidence of carotid atherosclerotic plaques was related to neurological deficits（NIHSS score） in patients with acute cerebral infarction.