应用CT血管成像检测颈动脉斑块及狭窄与短暂性脑缺血发作的关系研究  

The Relationship between Transient Ischemic Attack and Carotid Plaque and Stenosis Using CT Angiography

作　　者：刘晓红[1] 吴玉芙[1] 臧婷臻[1] 王浩然[1] 潘克梫[2] 

机构地区：[1]北京老年医院神经内科,北京市100095 [2]清华大学医院放射科

出　　处：《中国全科医学》2013年第33期3916-3919,共4页Chinese General Practice

摘　　要：目的应用CT血管成像(CTA)检测,探讨颈动脉斑块及狭窄与短暂性脑缺血发作(TIA)的关系。方法选取2010-01-01—2013-01-01在本院就诊的颈内动脉系统的TIA患者113例(观察组)及同期非脑血管疾病患者55例(对照组)。两组患者均行多排螺旋CT血管成像(MDCTA)检测是否存在颈动脉斑块及颈动脉狭窄,并对颈动脉受累情况、斑块类型及其在颈动脉各段的分布情况、颈动脉狭窄程度进行比较。结果 (1)观察组颈动脉斑块检出率〔88.5%(100/113)〕、颈动脉狭窄检出率〔70.8%(80/113)〕均高于对照组〔45.5%(25/55)和29.1%(16/55)〕(χ2值分别为3.211和9.002;P值分别为0.000和0.003)。观察组颈动脉狭窄患者中,颈动脉轻度、中度、重度狭窄及完全闭塞者分别为21例(26.2%)、24例(30.0%)、22例(27.5%)以及13例(16.3%)。(2)观察组和对照组分别有93例(82.3%)、13例(23.6%)颈动脉多支血管存在斑块,两组间差异有统计学意义(χ2=4.218,P=0.045)。(3)两组斑块类型分布间差异有统计学意义(P<0.05),其中对照组以硬斑块为主(54块,占52.9%),观察组以软斑块为主(307块,占42.5%)。观察组中,软斑块、硬斑块、混合斑块在颈动脉各段的分布差异均有统计学意义(P<0.05);其中软斑块主要出现在颈总动脉(CCA)中(152块,占49.6%),而硬斑块主要出现在颈内动脉颅内段(ICA-I)(129块,占46.9%)。结论 MDCTA可检测颈动脉斑块及评估颈动脉狭窄程度,发现TIA患者颈动脉斑块及狭窄检出率均高于非脑血管疾病患者;TIA患者颈动脉斑块以软斑块为主,CCA多出现软斑块;提示颈动脉斑块形成及其导致的颈动脉狭窄是引发TIA的重要因素。Objective To discuss the relationship between transient ischemic attack （TIA） and carotid plaque and stenosis using CT angiography （CTA） . Methods From 2010 -01 -01 to 2013 -01 -01, 113 cases with TIA were included in observation group, 55 cases without cerebrovascular disease were included in the control group. Multi - director CT angiography （MDCTA） was used to detect carotid plaque and stenosis in all cases, and the severity of carotid plaque, plaque type, plaque distribution in various segments of carotid, extent of carotid stenosis were compared between two groups. Results （ 1 ） Both ca- rotid plaque detection rate [ 88.5% （ 100/113 ） ~ and carotid stenosis detection rate [ 70. 8% （ 80/113 ） ] in observation group were significantly higher than those [ 45.5 % （25/55） and 29. 1% （16/55） ~ in control group （ X2 = 43.211, P = 0. 000 ; X2 = 9. 002, P = 0. 003 ） . Among patients with carotid stenosis in observation group, there were 21 cases （26. 2% ） of mild steno- sis, 24 cases （30.0%） of moderate stenosis, 22 cases （27.5%） of severe stenosis, 13 cases （16.3%） of occlusion. （2） In the observation group, carotid multi vessel plaque was found in 93 cases （82. 3% ） , in the control group, carotid multi ves- sel plaque was found in 13 patients （23.6%）, the difference between two groups was statistically significant （X~ =4. 218, P = 0. 045 ） . （3） There was significant difference in the distribution of plaque type between the two groups （ P 〈 0. 05 ）, the plaque type in the control group was dominated by hard plaque （54, accounting for 52. 9% ）, the plaque type in the observation group was dominated by soft plaque （307, accounting for 42. 5 % ） . In the observation group, there was significant difference in the distribution of plaque type （soft plaque, hard plaque, and mixed plaque） in various segments of carotid （P 〈0.05） . Soft plaque occurred mainly in the common carotid artery （CCA） （ 152, accounting for 49.6%

关 键 词：脑缺血发作 短暂性 颈动脉狭窄 颈动脉斑块 

分 类 号：R743.31[医药卫生—神经病学与精神病学]