缺血性脑卒中患者颈动脉内-中膜厚度和斑块与颅内动脉粥样硬化关系的研究

摘要

目的 研究缺血性脑血管病(ischemic cerebrovascular disease,ICVD)患者颈动脉内-中膜厚度(common carotid artery intima media thickness,CCA-IMT)和斑块与颅内动脉粥样硬化的关系.方法 对374例ICVD患者进行颈部血管超声检查,根据结果分为颈动脉正常组、CCA-IMT增厚组、颈动脉斑块组,并对所有患者行颅内血管结构检查,将患者分为颅内动脉正常组、粥样硬化组,后者再分为轻度动脉粥样硬化组、单支动脉狭窄组、多支动脉狭窄组,分析CCA-IMT与颅内动脉粥样硬化的关系.结果 CCA-IMT增厚组患者颅内动脉粥样硬化的比率高,颈动脉斑块组患者颅内动脉粥样硬化、颅内动脉狭窄、多支动脉狭窄的比率高,年龄、高血压病、高脂血症与CCA-IMT增厚有关.结论 CCA-IMT增厚与颅内动脉粥样硬化有关,颈动脉斑块与颅内动脉狭窄关系密切,应积极控制高血压病、高脂血症,预防CCA-IMT增厚.%Objective To investigate the correlation between carotid intima-media thickness ( CCA-IMT ), carotid plaques, and the extent of intracerebral atherosclerosis in patients with ischemic cerebrovascular disease ( ICVD ). Methods Carotid vascular ultrasound and intracranial vascular structure check were examined in 374 patients with ICVD. According to the result of carotid vascular ultrasound, all patients were divided into normal carotid artery group, CCA-IMT thickening group and carotid plaque group. According to the structure of intracerebral artery, all the patients were divided into normal intracerebral artery group and atheroscleresis group, and the latter group was subdivided into mild atheroscleresis group, single artery stenosis group and multiple artery stenosis group. Analysis was performed on the relationship between CCA-IMT and intracerebral atherosclerosis. Results Compared with normal groups,the rate of intracerebral atherosclerosis in CCA-IMT group was higher. The rates of intracerebral atherosclerosis and arterial stenosis and multiple intracranial artery stenosis in carotid plaque patients were higher. Patients with ICVD disease accompanied by older age, hypertension, hyperlipidemia were more likely subjected to increased CCA-IMT value. Conclusion The thickening of CCA-IMT is related with the intracranial atherosclerosis. Carotid atherosclerotic plaque and intracranial artery stenosis are closely related. Hypertension and hyperlipidemia should be effectively controlled to prevent CCA-IMT thickening.