颈动脉粥样硬化与脑小血管病亚型的相关性研究  

Study on the Correlation Between Carotid Atherosclerosis and Cerebral Small Vessel Disease Subtypes

作　　者：李亚涓 章龙 陈玉兰 LI Yajuan;ZHANG Long;CHEN Yulan(Ganxian People’s Hospital,Ganxian 341100,Jiangxi,China)

机构地区：[1]赣州市赣县区人民医院,江西赣县341100

出　　处：《现代诊断与治疗》2024年第22期3325-3327,3330,共4页Modern Diagnosis and Treatment

基　　金：赣州市卫生健康委员会市级科研计划项目(项目编号:GZWJW202402317)。

摘　　要：目的探讨颈动脉粥样硬化(CAS)与脑小血管病(CSVD)亚型的相关性。方法将2022年7月至2024年6月我院收治的98例CSVD患者纳入病例组,50例健康者纳入参考组,均接受彩色多普勒超声检查,观察各组双侧颈总动脉、颈内动脉血流动力学参数及内-中膜厚度(IMT),比较不同组别IMT、颅外颈动脉血流动力学指标、管腔狭窄程度、斑块发生情况及斑块性质差异。结果病例组WML、CMBs亚型IMT高于参考组(P<0.05);病例组LI亚型IMT与参考组比较无明显差异(P>0.05);病例组各亚型双侧D均高于参考组,LI、CMBs亚型双侧SPV均低于参考组,WML亚型右侧SPV低于参考组(P<0.05);病例组各亚型RI与参考组比较无明显差异(P>0.05);病例组WML亚型狭窄程度≥50%比例高于其他亚型及参考组(P<0.05);病例组LI、CMBs亚型颅外颈动脉管腔狭窄程度与参考组比较无明显差异(P>0.05);病例组各亚型斑块发生率均高于参考组,且CMBs、WML亚型斑块发生率高于LI亚型(P<0.05);病例组CMBs与WML亚型斑块发生率比较无明显差异(P>0.05);病例组CMBs、WML亚型不稳定斑块比例高于LI亚型与参考组(P<0.05);病例组CMBs与WML亚型不稳定斑块比例、LI亚型不稳定斑块比例与参考组比较无明显差异(P>0.05)。结论CAS对CSVD各亚型影响不同,更易诱发CMBs、WML,不同亚型IMT、血流动力学参数、斑块发生率及斑块性质差异明显,临床可通过检测CAS判断CSVD亚型,指导治疗。Objectives To explore the correlation between carotid atherosclerosis(CAS)and subtypes of cerebral small vessel disease(CSVD).Methods A total of 98 patients with CSVD admitted to our hospital from July 2022 to June 2024 were included in the case group,and 50 healthy individuals were included in the reference group.All patients underwent color Doppler ultrasonography.The hemodynamic parameters and intima-media thickness(IMT)of bilateral common carotid arteries and internal carotid arteries.The IMT,extracranial carotid artery hemodynamic indices,degree of luminal stenosis,incidence of plaque occurrence and differences in plaque characteristics.Results The IMT of WML and CMBs subtypes in the case group was significantly higher than that in the reference group(P<0.05).There was no significant difference in IMT of LI subtype between the case group and the reference group(P>0.05).The bilateral D values of all subtypes in the case group were significantly higher than those in the reference group,and the bilateral SPV values of the LI and CMBs subtypes were significantly lower than those in the reference group,while the right SPV value of the WML subtype was significantly lower than that in the reference group(P<0.05).There was no significant difference in RI of each subtype between the case group and the reference group(P>0.05).The proportion of WML subtype stenosis≥50%in the case group was significantly higher than that in other subtypes and the reference group(P<0.05).There was no significant difference in the degree of extracranial carotid luminal stenosis between the LI and CMBs subtypes in the case group and the reference group(P>0.05).The incidence of plaques in all subtypes in the case group was significantly higher than that in the reference group,and the incidence of plaques in the CMBs and WML subtypes was significantly higher than that in the LI subtype(P<0.05).There was no significant difference in the incidence of plaques between the CMBs and WML subtypes in the case group(P>0.05).The proportion of unstab

关 键 词：颈动脉粥样硬化 腔隙性梗死 脑小血管病 脑微出血 内-中膜厚度 

分 类 号：R743.33[医药卫生—神经病学与精神病学]