颈动脉狭窄的危险因素与缺血性卒中的相关性分析  

Correlation Between Risk Factors of Carotid Artery Stenosis and Ischemic Stroke

作　　者：郑宇[1] 华扬[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,北京市100053

出　　处：《中国超声诊断杂志》2004年第1期4-6,共3页Chinese Journal of Ultrasound Diagnosis

摘　　要：目的 :分析动脉硬化性颈动脉狭窄 (carotid artery stenosis,CAS)病变的危险因素、狭窄程度、斑块特性与缺血性脑卒中的关系。方法 :采用双功能彩色多普勒超声仪 ,将 1 6 0 3例首诊患者 ,分非狭窄组 (A组 :狭窄 <5 0 % )与狭窄组 (B组 :狭窄 >5 0 %或闭塞 )对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>5 0 %者占 1 7.3% (2 77/ 1 6 0 3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 .0 2 4、 0 .777、 0 .82 7、 0 .76 2、 0 .75 0 )。 B组患者卒中发生率为 37.5 % (1 0 3/ 2 77) ,明显高于 A组 2 1 .6 % (2 87/ 1 32 6 ) ,P<0 .0 0 1。 B组中 CAS 5 1 %～ 6 9%的患者中风发生率 30 .4 % (38/ 1 2 5 ) ;CAS≥ 70 %或闭塞者中风发生率为 4 2 .8% (6 5 / 1 5 2例 )。斑块的发生率为 6 4 .3%(1 0 32 / 1 6 0 3) ,其中中风及短暂脑缺血发作 (Transient ischemic attack,TIA)患者的不规则、不均质回声斑块的比率高于非中风患者 ,P<0 .0 0 1。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 ;Objective:To study the risk factors of carotid artery stenosis(CAS) and the relationship of the degree of stenosis and characteristics of plaques with ischemic stroke occurrence.Methods:CDFI was used to study the morphology,structure,and hemodynamics of bilateral carotid arteries in 1 603 initial examined patients,and to emphasize the degree of stenosis and echo characteristics of plaques.The data about the risk factors of atherosclerosis and ischemic stroke occurrence were recorded.The patients were divided into A(stenosis<50%)and B(stenosis>50%.or occlusion)groups.Results:Carotid stenosis was found in 277 patients(17 3%).Older age,male,hypertension,ischemic cardiac disease and diabetes mellitus were in close relation to carotid stenosis ( r =0 024?0 777?0 827?0 762?0 750 respectively).The stroke incidence in the group B was 37 5%(103/277)which was higher than that of group A,21 6%(287/1 326, P <0 001) In the group B,the stroke occurrence of CAS was between 51-69%,(30 4%,38/125),while that of CAS greater than 70% or occlusion was 42 8%(65/152) The total plague occurrence was 64 3% (1 032/1 603).The incidence ratio of irregular and heterogeneous plaques was higher in patients with stroke and TIA than those without.Conclusions:Older age,male,hypertension,ischemic cardiac disease and diabetes mellitus are all risk factors of CAS.The stroke occurrence is higher along with the increment of stenosis degree.Irregular and heterogeneous plaques also have relationship with stroke.

关 键 词：颈动脉狭窄 危险因素 缺血性卒中 相关性 动脉硬化 彩色多普勒超声 血流动力学 

分 类 号：R543.4[医药卫生—心血管疾病] R743.3[医药卫生—内科学]