颈动脉斑块与缺血性脑血管病及其危险因素的关系  

The association between carotid plaque and ischemic cerebrovascular disease and its risk fators

作　　者：朱双根[1] 朱幼玲[1] 唐发霞[1] 穆燕芳[1] 

机构地区：[1]安徽省合肥市第一人民医院神经内科,230061

出　　处：《临床超声医学杂志》2007年第4期220-223,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨缺血性脑血管病患者颈动脉粥样硬化斑块特点及其与缺血性脑血管病之间的关系,寻找颈动脉斑块危险因素。方法对115例颈内动脉粥样硬化缺血性脑血管病患者进行颈动脉超声检查,并检查血清甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白,分析引起颈动脉粥样硬化的危险因素。结果超声检查颈动脉粥样硬化斑块检出率为81.7%(94例),颈动脉中重度狭窄发生率为7.8%(9例)。缺血侧颈动脉斑块发生率(67.7%),其中软斑发生率(33.1%),均高于非缺血侧(48.5%,其中软斑20.4%,P<0.05)。斑块组发生高血压病的比例(85.1%)明显高于无斑块组(57.1%,P<0.05);且在软斑组长期烟酒史及男性比例高于稳定性斑块组(P<0.05)。结论缺血性脑血管病患者颈动脉粥样硬化以斑块居多,软斑为重要危险因素,高血压病在斑块发生发展中起重要作用。多因素分析表明,年龄、甘油三酯、总胆固醇和低密度脂蛋白影响颈动脉斑块的形成,而性别、烟酒史可能会影响斑块的稳定性。Objective To study the relationship between the characteristic of carotid atherosclerosis plaque and ischemic cerebrovascular disease and to find risk factors. Methods The duplex ultrasonography was performed in the carotid arteries of all the 115 patients（stroke 101 cases, TIA 14 cases） with isehemic cerebrovaseular disease located in arteriae interna system. Triglyeride, total cholesterol, high - density lipoproteins, low - density lipoprotein and other risk factors of athorosclerosis were detected , too. Results Carotid plaque were found in 94 （81.7 % ） patients, and the prevalence of severe lumen stenosis was 7.8 %. The incidence of carotid plaque in the ischemic side was found to be 67.7 %, soft plaque in that was 33.1%, the incidence were higher than that of non - ischemic side（48.5% ,soft plaque in that was 20.4%, P 〈 0.05）. Ratio of hypertension in carotid plaque（85.1% ） was higher than that of non plaque group（57.1%, P 〈 0.05）. Ratio of male ,smoking and drink in soft plaque group was higher than that of instability plaque group（ P 〈 0.05）. Conclusion Most of the carotid artery lesion are plaques other than severe lumen stenosis. The soft plaque is an important risk factor of ischomic cerebrovaseular disease in our study . Hypertension play a important role in form of carotid plaque. The multivariable analysis showed that age, Triglyefide, total cholesterol and low- density lipoprotein could affect the form of carotid plaque too. Differences of male , smoking and drink may affect instability of caroid plaque.

关 键 词：颈动脉 斑块 缺血性脑血管病 危险因素 

分 类 号：R743.31[医药卫生—神经病学与精神病学]