急性前循环缺血性脑卒中与颈动脉粥样硬化斑块的相关性研究

The correlation between acute anterior circulation ischemic stroke and carotid atherosclerotic plaque

目的分析急性前循环缺血性脑卒中与颈动脉斑块的性质、狭窄率、分布之间的关系,探讨颈动脉斑块的影响因素。方法收集诊断为急性前循环缺血性脑卒中的患者188例,选取同期非脑梗死患者150例为对照组。均行颈部血管彩色多普勒超声及血液生化检查,比较两组之间的斑块稳定性、分布差异,分析颈动脉斑块的形成因素。结果脑梗死患者颈动脉斑块的检出率(72.3%)高于对照组患者(54.7%)(χ~2=11.38,P<0.01)。脑梗死组比对照组不稳定斑块检出率更高(54.8%比31.3%,χ~2=18.59,P<0.01)。与对照组相比,脑梗死患者颈动脉狭窄率更高(P<0.01),分布范围更广,双侧颈动脉斑块检出率更高(P<0.05)。相关分析显示,颈动脉斑块的形成与年龄、性别、高血压和吸烟有关。结论颈动脉粥样硬化斑块是急性前循环缺血性脑卒中的重要危险因素。颈动脉斑块的形成与年龄、性别、高血压、吸烟相关。

Objective To analyze the relationship between acute ischemic stroke of anterior circulation and characteristics,stenosis rate,distribution of carotid atherosclerotic plaque,explore the influence factors of carotid artery plaque. Methods A total of 188 patients with acute ischemic stroke of anterior circulation and 150 control individuals with non- cerebral infarction were consecutively recruited. All individuals were examined by color Doppler ultrasound for the stenosis of extracranial carotid arteries and blood biochemical. The plaque stability,distribution of carotid atherosclerotic plaques were compared between two groups,and the formation factors of carotid plaque were analyzed. Results The detection rate of carotid plaque in patients with cerebral infarction( 72. 3%) was higher than that of the control group( 54. 7%)( χ~2= 11. 38,P < 0. 01). Compared with the control group,the detection rate of unstable plaque of cerebral infarction group was higher( 54. 8% VS. 31. 3%,χ~2= 18. 59,P < 0. 01). Patients with cerebral infarction had higher rate of carotid stenosis,wider distribution,and higher detection rate of bilateral carotid artery plaque( P < 0. 05). The correlation analysis showed that the formation of carotid plaque was associated with age,sex,hypertension and smoking. Conclusion Carotid atherosclerosis is one of the important risk factors of acute anterior circulation ischemic stroke. There is a significant association between the formation of carotid atherosclerotic lesions and the age,gender,hypertension and smoking.