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目的探讨彩色多普勒超声检测糖尿病合并脑梗死患者的颈动脉粥样硬化斑块的临床价值。方法对136例糖尿病合并脑梗死患者和136例单纯脑梗死患者进行检查,应用彩色多普勒超声仪检测探测双侧颈总动脉(CCA)、颈总动脉分叉处(BIF)及颈内动脉(ICA)颅外段,并记录颈动脉中膜厚度(IMT)、管腔内径、粥样硬化斑块数量、部位。结果糖尿病合并脑梗死组的粥样硬化斑块的检出率为83.2%,单纯脑梗死组粥样硬化斑块的检出率为75.3%,两组间比较差异有统计学意义(P<0.05);以颈总动脉分叉处最多,其次是颈总动脉,颈内动脉颅外段最少。右侧多于左侧,两侧间比较差异有统计学意义(P<0.05)。糖尿病合并脑梗死组CCA内径明显小于单纯脑梗死组(P<0.05)。糖尿病合并脑梗死组颈动脉狭窄总数及重度狭窄数较单纯脑梗死组高,两者比较差异有统计学意义(P<0.05)。另外,糖尿病合并脑梗死组颈动脉狭窄以中、重度为主,共有90例(66.2%),单纯脑梗死组颈动脉中、重度狭窄74例(54.4%),两者比较差异有统计学意义(P<0.05)。结论颈动脉粥样斑块与糖尿病合并脑梗死发生有密切关系。糖尿病患者合并脑梗死的患者其动脉粥样硬化的情况更严重,容易导致严重颈动脉狭窄。
Objective To investigate the clinical value of color Doppler ultrasound in the detection of carotid atherosclerosis plaques in patients with diabetes complicated with cerebral infarction. Methods One hundred and sixty-six patients with diabetes mellitus complicated with cerebral infarction and 136 patients with simple cerebral infarction were examined by color Doppler sonography. Detection of bilateral common carotid artery (CCA), common carotid artery bifurcation (BIF) and internal carotid artery (ICA) extracranial segments, and recorded carotid intima-media thickness (IMT), lumen diameter, atherosclerotic plaque number and location. Results The detection rate of atherosclerotic plaque was 83.2% in diabetic patients with cerebral infarction and 75.3% in simple cerebral infarction group. The difference between the two groups was statistically significant (P <0.05 ); The common carotid artery bifurcation at most, followed by the common carotid artery, internal carotid artery extracranial segment at least. Right than the left, the difference between the two sides was statistically significant (P <0.05). Diabetic patients with cerebral infarction CCA diameter was significantly smaller than the group of cerebral infarction (P <0.05). The total number of carotid stenosis and severe stenosis in patients with diabetes mellitus complicated with cerebral infarction were higher than that in patients with simple cerebral infarction. The difference was statistically significant (P <0.05). In addition, 90 patients (66.2%) had carotid artery stenosis in diabetes mellitus complicated with cerebral infarction group, 74 patients (54.4%) had severe carotid artery stenosis in simple cerebral infarction group, the difference was statistically significant (P <0.05). Conclusion Carotid artery plaque is closely related to the occurrence of cerebral infarction in diabetes mellitus. Patients with diabetes mellitus complicated by cerebral infarction are more atherosclerotic and easily lead to severe carotid artery stenosis.