颈部动脉硬化斑块形态与缺血性脑梗死发生的研究

摘要

目的 根据颈部动脉硬化斑块的形态及内部结构,筛选出缺血性脑梗死的高危人群,前瞻性预防缺血性脑梗死的发生.方法 选择脑梗死组患者51例,同时设对照组51例,应用彩色多普勒超声诊断仪检测颈部动脉,测量血管内膜厚度,观测颈部动脉硬化斑块的部位,重点观察斑块的形态及内部结构,并根据斑块的形态及内部回声,将颈部动脉硬化斑块进行形态学分类.结果脑梗死组斑块检出率为94.1%,对照组斑块检出率为23.5%.在斑块的形态学中,脑梗死组以软斑、溃疡性斑块为主,占80.7%,对照组软斑及溃疡斑块占21.1%,对照组以扁平斑为主,占63.2%,两组在斑块检出率及形态学方面比较,差异有统计学意义(P < 0.05).结论 颈部动脉硬化斑块的形态及内部结构与脑梗死的发生有相关性,根据彩色多普勒对颈部血管硬化斑块的形态及内部结构检查结果,对脑梗死的高危人群行早期的系统治疗及指导其健康的生活方式,可前瞻性预防缺血性脑梗死的发生,通过系列的干预措施,对降低脑梗死的发生有重要的临床意义.%Objective To screen out the high risk population of ischemic cerebral infarction according to the morphology and internal structure of carotid atherosclerotic plaque, in order to prevent the occurrence of ischemic cerebral infarction prospectively. Methods There were 51 patients in the cerebral infarction group and 51 patients in the control group. The color Doppler ultrasonic diagnostic apparatus was used to detect the carotid artery, measure the intimal thickness and observe the location of carotid atherosclerotic plaque especially the morphology and internal structure of plaque. Carotid atherosclerotic plaque was proceeded morphological classification, according to the morphology and internal echo of plaque. Results The detection rate of plaque was 94.1% in the cerebral infarction group and 23.5% in the control group. As to the morphology of plaque, soft plaque and ulcerative plaque were the majority in the cerebral infarction group, accounting for 80.7%, but accounted for 21.1% in the control group; flat plaque was the majority in the control group, accounting for 63.2%. The two groups were significantly different in the detection rate and morphology of plaque (P < 0.05). Conclusion The morphology and internal structure of the carotid atherosclerotic plaque are correlated to the occurrence of cerebral infarction. According to the morphology and internal structure detected by the color Doppler ultrasonic diagnostic apparatus, early systemic treatment and healthy living style guidance of high risk population of cerebral infarction can prevent the occurrence of ischemic cerebral infarction prospectively, which has important clinical significance in the reduction of cerebral infarction through series of intervention measures.