急性症状性颈动脉狭窄患者斑块特征与微栓子信号的相关性研究  

The correlation between characteristics of plaque and microembolic signals in patients with acute symptomatic carotid artery stenosis

作　　者：杨梅[1] 居克举[1] 仲玲玲 孙波 曹化[1] 丁涟沭[1] YANG Mei;JU Keju;ZHONG Lingling(The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University,Huai’an 223300,China)

机构地区：[1]南京医科大学附属淮安市第一医院,江苏淮安223300

出　　处：《中风与神经疾病杂志》2018年第6期538-540,共3页Journal of Apoplexy and Nervous Diseases

基　　金：淮安市卫生局(No.HAS2015018-3)

摘　　要：目的研究症状性颈动脉狭窄(SCAS)患者的斑块特征与微栓子信号(MES)的关系。方法通过经颅多普勒(TCD)监测症状性及非症状性颈动脉狭窄(ACAS)患者同侧大脑中动脉的MES。应用彩色超声检测同侧颈总、颈内动脉斑块,根据声像学特征将斑块分为3个等级,分析MES与不同等级的斑块的相关性。结果症状性和非症状性颈动脉狭窄组患者在年龄、性别、合并症等方面无显著性差异(P>0.05)。SCAS组大于70%狭窄率患者较多,Ⅲ级斑块明显偏多(P<0.05);在MES检测中,SCAS组阳性率显著高于ACAS组(P<0.01),狭窄率大于70%的病例高于狭窄率小于70%的病例(P<0.05);Ⅲ级斑块患者的MES阳性率显著高于其他类型(P<0.05),且斑块的等级与MES阳性呈正相关(r=0.227,P=0.010)。结论 MES的出现与症状性颈动脉狭窄患者的斑块的不稳定性相关,可以作为不稳定颈动脉斑块的特征之一应用于临床。Objective To investigate the relationship between characteristic of carotid plaque and microembolic signals（ MES） in patients with symptomatic carotid artery stenosis（ SCAS）. Methods The MES of the ipsilateral middle cerebral artery in patients with symptomatic and asymptomatic carotid artery stenosis was monitored with Transcranial Doppler（ TCD）. The characteristic of carotid plaque was detected with colour doppler ultrasound,and divided into three grades according to the sonographic characteristics. The correlation between MES and different grades of plaques was analyzed.Results There was no significant difference in age,gender,comorbidity between symptomatic and asymptomatic carotid artery stenosis patients（ P 0. 05）. There were more patients with stenosis rate greater than 70% and more grade Ⅲ plaques in SCAS group（ P 0. 05）. In the MES test,the positive rate of MES in SCAS group was significantly higher than ACAS group（ P 0. 01）,the cases with stenosis rate more than 70% were higher than those less than 70%（ P 0. 05）; and the MES-positive patients with grade Ⅲ plaques were more popular than the other grades（ P 0. 05）,and the grade of plaque was positively correlated with the positive rate of MES（ r = 0. 227,P = 0. 010）. Conclusion The appearance of MES is related to the instability of plaque in patients with symptomatic carotid artery stenosis. It can be used clinically as one of the features of unstable carotid plaque.

关 键 词：微栓子 经颅多普勒 颈动脉狭窄 斑块 超声 脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]