动脉粥样硬化危险因素与颈动脉狭窄和缺血性卒中的相关性  

The relationship between the risk factors of arteriosclerosis and carotid stenosis as well as ischemic stroke

作　　者：华扬[1] 郑宇[1] 凌晨[1] 段春[1] 张蕾[1] 王力力[1] 刘玉梅[1] 周瑛华[1] 

机构地区：[1]首都医科大学宣武医院超声科,100053

出　　处：《中国脑血管病杂志》2004年第2期69-72,共4页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的 分析动脉粥样硬化性颈动脉狭窄(CAS)病变的危险因素、狭窄程度、斑块特性与缺血性卒中的关系。 方法 采用双功能彩色多普勒超声仪,将1603例首诊患者分为非狭窄组(A组:狭窄<50％)与狭窄组(B组:狭窄>50％或闭塞),对患者的双侧颈动脉斑块形态、结构及血流动力学结果及年龄、性别、危险因素、卒中的发病与CAS程度进行统计分析。 结果 CAS>50％者占17.3％(277/1603例)。高龄、男性、高血压病、冠心病、糖尿病与CAS的形成显著相关(r=0.024、0.777、0.827、0.762、0.750)。B组患者卒中发生率明显高于A组,分别为37.20%(103/277)和21.6％(287/1326),P<0.001。B组中CAS 51％-69％的患者卒中发生率30.4％(38/125);CAS-70％或闭塞者卒中发生率为42.8％(65/152例)。斑块的发生率为64.4％(1032/1603),其中卒中及TIA患者的不规则、不均质回声斑块的比率高于非卒中患者,P<0.001。结论 CAS与高龄、男性、高血压、冠心病、糖尿病显著相关;随狭窄程度的增加卒中的危险性升高;且超声显示不均质回声斑块的形成与卒中的发生有关系。Objective To study the relationship between the risk factors of carotid stenosis, the degree of stenosis, the characteristics of plaques and the occurrence of ischemic stroke. Methods Color doppler flow imaging CDFI was used to study the morphology, structure, and hemodynamic of bilateral carotid arteries in 1603 initial examined patients, emphasizing the degree of stenosis, echo-character of plaques; the data of the risk factors of atherosclerosis and ischemic stroke occurrence were recorded. The patients were divided into A and B groups according to the degree of stenosis (≤50% or >50% and occlusion). Results Carotid stenosis was found in 277 patients (17. 3%); old age, male, hypertension, ischemic cardiac disease, diabetes mellitus were in close relation with carotid stenosis (r=0. 024、0. 777、0. 827、0. 762、0. 750). The stroke incidence in the group A was higher than the group B, 37. 2% (103/277) and 21. 6% (287/1326) respectively, P<0.001. In the group A, the stroke incidence of CAS between 51%-69% was 30. 4% (38/125); while CAS greater than 70% or occlusion was 42. 8% (65/152). Plaques incidence was 64. 4% (1032/1603), in which irregular, heterogeneous plaque happened in a higher ratio in patients with stroke and TIA. Conclusion Old age, male, hypertension, cardiac disease, diabetes mellitus were risk factors of carotid stenosis; the stroke incidence increase with the increment of degree of stenosis; irregular and heterogeneous plaque had relation with ischemic stroke.

关 键 词：动脉粥样硬化 危险因素 颈动脉狭窄 缺血性卒中 相关性 

分 类 号：R543[医药卫生—心血管疾病]