颈动脉斑块病理特点与临床表现的相关性

Correlation between pathological features and clinical manifestations of carotid plaque

目的:探讨颈动脉斑块病理特点与临床表现的相关性。方法:488例患者(共562次CEA)术前分为3组:无症状组、症状组和卒中组。将颈动脉斑块按形态分为普通斑块、溃疡斑块、出血斑块和溃疡伴出血斑块,按分期分为4期、5期和6期斑块,统计不同形态和分期与临床症状的相关性。结果:普通斑块、溃疡斑块、溃疡伴出血斑块、4期、5期和6期斑块在无症状组和症状组的发生率均存在显著性差异(均P<0.01)。普通斑块、溃疡伴出血斑块、4期、5期和6期斑块在卒中组的发生率分别为10.3%、29.9%、11.3%、21.7%和67.0%,与无症状组、症状组比较均存在显著性差异(P<0.05,P<0.01)。溃疡和出血的发生率在重度狭窄中的比例高于中度狭窄。结论:颈动脉斑块病理形态是临床预后的重要因素,溃疡斑块或6期斑块与临床症状的发生密切相关。

Objective:To investigate the correlation between pathological characteristics and clinical manifestations of carotid plaque.Methods:Patients of 488 cases(562 CEA)were divided into three groups:asymptomatic group,symptomatic group and stroke group.The carotid plaques were divided into common plaque,ulcerous plaque,bleeding plaque and ulceration with bleeding plaque according to their morphology.They were also divided into stage 4,stage 5 and stage 6 according to the staging creteria.The correlation between different forms and stages and clinical symptoms was analyzed.Results:There were significant differences in the incidence of common plaque,ulcerous plaque,ulceration with bleeding plaque,stage 4,stage 5 and stage 6 plaques between the asymptomatic group and the symptomatic group(all P<0.01).The incidences of common plaque,ulcer with bleeding plaque,stage 4,stage 5 and stage 6 plaques in stroke group were 10.3%,29.9%,11.3%,21.7%and 67.0%,respectively,which were significantly different from those of the asymptomatic group and the symptomatic group(P<0.05,P<0.01).The incidence of ulceration and bleeding was higher in severe stenosis than in moderate stenosis.Conclusion:Pathological morphology of carotid plaque is an important factor in clinical prognosis.Ulcerous plaque or stage 6 plaque is closely related to the occurrence of clinical symptoms.