颈动脉狭窄与缺血性进展性脑卒中的关系研究  

Relationship between carotid stenosis and ischemic stroke in progression

作　　者：毛玲群[1] 齐玉祥[1] 张晓芳[1] 张丹红[1] 

机构地区：[1]台州市中心医院神经内科,浙江台州318000

出　　处：《中国中西医结合急救杂志》2013年第1期45-47,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省台州市科技计划项目（081KY06）

摘　　要：目的探讨颈动脉狭窄程度与缺血性进展性脑卒中（SIP）的关系。方法回顾性分析2009年1月至2011年12月本院收治的119例SIP患者的临床基本资料，在患者人院时及人院72h后采用改良欧洲Skandinavien卒中量表（MESSS）评价患者的神经功能，应用颈动脉超声、螺旋CT动脉血管造影（CTA）评价颈动脉血管狭窄程度，分析颈动脉不同狭窄程度患者的缺血性卒中进展情况。结果119例患者中颈动脉轻度狭窄89例（74．8％），中度12例（10．1％），重度狭窄10例（8．4％），完全闭塞8例（6．7％）。随着狭窄程度的加重，MESSS下降率不断增加[轻度（18．0±1．3）％、中度（26．0±2．2）％、重度（35．0±1．9）％]，完全闭塞组明显减少[（11．0±0．7）％]，各组间比较差异有统计学意义（P〈0．01）。非闭塞组与闭塞组脑缺血发生率（52．3％比37．5％）比较差异无统计学意义（P=0．193）。结论颈动脉狭窄程度可以作为预测SIP的指标；通过颈动脉超声、CTA可能为脑梗死的急性期进展提供有意义的资料。Objective To investigate the relationship between the degree of carotid stenosis and ischemic stroke in progression （SIP）. Methods A retrospective analysis was conducted in 119 patients with SIP admitted at Taizhou Central Hospital from January 2009 to December 2011. We analyzed their basic clinical data, and evaluated their neurological functions on admission and 72-hour after admission by the Modified European Skandinavien Stroke Scale （MESSS） scoring criteria, using carotid ultrasound and spiral CT arterial angiography （CTA） to assess their degrees of carotid stenosis, to search for the progression of ischemic stroke in patients with different levels of carotid artery stenosis. Results Based on their levels of carotid artery stenosis, 119 patients were divided into four groups ： mild group （89 cases, 74.8%）, medium group （ 12 cases, 10.1%）, severe group （ 10 cases, 8.4%） and occlusion group （8 cases, 6.7%）. Along with the increase of severity of stenosis, the MESSS descending rates showed a trend of consecutive increase ： mild group （18.0＋ 1.3） % ; medium group （26.0＋2.2） % ; severe group （35.0＋ 1.9） % ; and remarkably declined occlusion group （11.0 ＋ 0.7） %. Significant differences were noted among the four groups （P〈 0.01 ） . There were no significant differences in the incidences of cerebral ischemia between non-occlusion group and occlusion group （52.3% vs. 37.5%, P=0.193）. Conclusions The degree of carotid stenosis can be used as an indicator to predict the SIP. The examinations of carotid artery ultrasound and CTA can provide useful information for the progression in acute phase of cerebral infarction.

关 键 词：进展性卒中 颈动脉狭窄 发病机制 

分 类 号：R743.3[医药卫生—神经病学与精神病学]