颈动脉粥样硬化合并斑块形成与前循环进展型脑梗死的相关性研究

摘要

目的：探讨颈动脉不稳定斑块与前循环进展型脑梗死之间的关系。方法前循环进展型脑梗死患者84例，于起病后5 h和第7天应用颈动脉斑块Crouse评分、斑块指数及颈动脉内-中膜厚度（IMT）评价双侧颈动脉粥样硬化和斑块病变程度，同时进行神经功能评定。结果病情进展前后，非责任病灶侧颈动脉斑块Crouse评分、斑块指数及IMT比较差异均无统计学意义，责任病灶侧颈动脉斑块Crouse评分、斑块指数及IMT比较差异均有统计学意义（P＜0．05）。病情进展后，责任病灶侧颈动脉斑块Crouse评分和斑块指数与NIHSS评分呈负相关（r=-0.752， P=0．005），IMT评分与NIHSS评分呈正相关（r=0.657，P=0．004）。结论前循环进展型脑梗死预后与责任病灶侧颈动脉硬化合并斑块形成的程度及斑块性质有关，责任病灶侧颈动脉斑块的Crouse评分、斑块指数及IMT对预测前循环进展型脑梗死预后有一定意义。%Objective To investigate the relationship between the clinical onset of progressive cerebral infarction in anterior cycle and properties of carotid atheromatous plaque. Methods A retrospective analysis was made on clinical data of 84 cases of progressive cerebral infarction in anterior cycle. At 5 h and seventh days after the onset, the carotid artery plaque Crouse score,index,and IMT were used to evaluate the carotid atherosclerosis and plaque lesions. In the meantime, NIHSS was applied to the evaluation of neural function defect. Results Before and after the progress of the disease, no statistical significance in Crouse score,index and IMT was found in non responsibility-lesion side. There was statistical significance in Crouse score, index and IMT in responsibility-lesion side(P<0.05). After the progress of the disease,Crouse score and index of the carotid artery plaque in responsibility-lesion sidewere negatively correlated with NIHSS (r=-0.752, P=0.005), but IMT was positively correlated with NIHSS (r=0.657, P=0.004). Conclusion The prognosis of progressive cerebral infarction in anterior cycle is correlated with the carotid sclerosis degree and plaque character, Crouse score,index and IMT of the lesion is valuabe in predicting prognosis of cerebral infarction in anterior cycle.