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目的探讨脑梗死与颈动脉粥样硬化斑块的相关性。方法采用彩色多普勒血流成像技术对434例脑梗死患者进行检测,观察其梗死侧和非梗死侧颈动脉内中膜厚度、斑块的部位、大小及其数目、动脉狭窄程度以及血流动力学改变等,并与248例对照组颈动脉粥样硬化斑块检出情况进行比较。结果脑梗死组患者的颈动脉粥样硬化斑块检出率为72.8%,显著高于对照组(25.0%,P<0.01)。颈动脉粥样硬化斑块多发生在脑梗死病灶的同侧,占85.0%,非梗死侧为12.6%;以颈总动脉分叉处居多,占58.4%。多因素Logistic回归分析显示斑块大小及其数量、峰值流速、搏动指数与脑梗死有明显的相关性(P<0.05),而两侧颈动脉内中膜厚度、狭窄程度无明显差异(P>0.05)。结论脑梗死的发生与颈动脉粥样硬化斑块密切相关,防止斑块的形成对防治脑梗死的发生有非常重要的意义。
Objective To investigate the correlation between cerebral infarction and carotid atherosclerosis plaque. Methods 434 patients with cerebral infarction were examined by color Doppler flow imaging. The intima-media thickness, plaque location, size and number of the carotid intima-media thickness, arterial stenosis and blood flow Kinetic changes, etc., and compared with 248 cases of control carotid atherosclerotic plaque were compared. Results The detection rate of carotid atherosclerosis in cerebral infarction group was 72.8%, which was significantly higher than that in control group (25.0%, P <0.01). Carotid atherosclerotic plaques occurred on the same side of the cerebral infarction, accounting for 85.0%, non-infarct side of 12.6%; carotid artery bifurcation, accounting for 58.4%. Multivariate Logistic regression analysis showed that plaque size and number, peak velocity and pulsatility index were significantly correlated with cerebral infarction (P <0.05), while there was no significant difference in carotid intima-media thickness and stenosis between two groups (P> 0.05). Conclusion The occurrence of cerebral infarction is closely related to carotid atherosclerotic plaque, preventing plaque formation is very important for the prevention and treatment of cerebral infarction.