颈动脉分叉类型对颈动脉粥样硬化形成的影响

Role of carotid bifurcation types in carotid atherosclerosis

探讨颈动脉分叉类型对颈动脉粥样硬化形成的影响。208例疑似颈动脉粥样硬化患者,根据颈动脉分叉部解剖学结构分为直分叉、直弯分叉、弯分叉。结果显示208例患者中颈动脉直弯分叉占46.16%(192/416),其次为弯分叉27.88%(116/416)、直分叉25.96%(108/416)。直分叉、弯分叉在右侧的构成比明显高于左侧,直弯分叉在右侧的构成比明显低于左侧(P<0.05)。不同颈动脉分叉类型的颈总动脉、颈内动脉中PSV、EDV、阻力指数之间差异无统计学意义(P>0.05);不同颈动脉分叉类型的PSV颈内动脉/PSV颈总动脉之间差异有统计学意义(P<0.05)。不同颈动脉分叉类型的心脏指数之间差异有统计学意义(P<0.05),直分叉的动脉粥样硬化斑块发生率明显高于直弯分叉、弯分叉(P<0.01);动脉粥样硬化斑块发生率在直弯分叉与弯分叉之间差异无统计学意义(P>0.05)。因此,颈动脉分叉类型能够对颈动脉血流速度、血流动力学参数产生影响,与颈动脉粥样硬化斑块形成有关。

To investigate the role of carotid bifurcation types in carotid atherosclerosis. 172 patients with suspected carotid atherosclerosis according to the-anatomical structure of the carotid bifurcation, the carotid bifurcation was divi-ded into straight bifurcation, straight bend bifurcation and curved bifurcation, and the formation of atherosclerotic plaque was observed. The Results showed that Among 172 patients, 55.81%(192/344) had straight bifurcation of carotid artery, 33.72%(116/344) had curved bifurcation and 10.47%(36/344) had straight bifurcation. The composition ratio of straight bifurcation and bending bifu-rcation on the right side was significantly higher than that on the left side, while the composition ratio of straight bifurcation and bending bifurcation on the right side was significantly lower than that on the left side(P<0.05). There was no significant difference in PSV, EDV and resistance index between common carotid artery and internal carotid artery of different types of carotid bifurcation(P>0.05);There was significant difference between common carotid artery of PSV and internal carotid artery of PSV of different types of carotid bifurcation(P<0.05), and the level of common carotidartery of PSV and internal carotid artery of curved bifurcation was significantlyhigher than that of straight bifurcation. there was significant difference in cardiac index between different types of carotid bifurcation(P<0.05), and the cardiac index of curved bifurcation was significantly lower than that of straight bifurcation. The incid-ence of atherosclerotic plaque in straight bifurcation was significantly higher than that in straight bifurcation and curved bifurcation(P<0.01), and there was no significant difference in the incidence of atherosclerotic plaque between straight bifurcation and curved bifurcation(P>0.05). So The type of carotid bifurcation can affect the blood flow velocity and hemodynamic parameters of carotid artery, which is related to the formation of carotid atherosclerotic plaque.