摘要
目的探讨各亚型缺血性脑卒中患者颈动脉内-中膜厚度(IMT)及斑块特点。方法 2011年3月至2015年9月吉林市中心医院及吉林医药学院附属医院缺血性脑卒中发作入院的患者489例作为研究组,其中大动脉粥样硬化型脑梗死(AI)组204例、腔隙性脑梗死(LI)组230例,心源性脑梗死(CI)组55例;以同期其他疾病就诊的患者500例为对照组,对照组排除既往脑卒中及冠状动脉粥样硬化性心脏病史。超声检查颈总动脉、颈动脉球部及颈内动脉IMT、有无动脉粥样硬化斑块形成及斑块发生率(颈总动脉、颈动脉球部或颈内动脉)。结果研究组IMT以及IMT增厚发生率均显著高于对照组(P<0.05);颈动脉斑块发生率AI组、LI组均显著高于CI组(均P<0.01);斑块形态分析显示,AI组、LI组多发斑块及不规则斑块发生率显著高于CI组(均P<0.05)。结论动脉粥样硬化是引起缺血性脑卒中的病理基础;缺血性脑卒中AI与LI患者发病早期应高度关注;AI/LI斑块特点或许可以作为区别AI/LI患者与CI的参考条件。
Objective To evaluate the association between ischemic stroke subtypes and characteristics of intima-media thickness（IMT） and carotid artery plaques detected by ultrasound screening. Methods Ischemic stroke patients（489 cases）,the test group,were stratified into 3 subgroups groups based on trial of ORG 10172 in acute stroke treatment（TOAST） standards as follows：atherothrombotic infarction（AI,n = 204）,lacunar infarction（LI,n = 230）,and cardioembolic infarction（CI,n = 55）. Other irrelevant disease cases（n = 500） were defined as the control group. IMT,with or without plaques,and plaque characteristics（formation,echo type,and number） were evaluated. Results A significant difference was detected in carotid artery IMT（common carotid artery,bulb,and internal carotid artery） between the two groups（all P〈0.05）. The incidence rates of plaques on the carotid artery in AI and LI were higher than that of CI（all P〈0.01）. Similarly,the incidence of multiple plaques and vulnerable plaques in the AI and LI groups were significantly higher than those in the CI group（all P〈0.01）. Conclusion Atherosclerosis is the pathological basis for ischemic stroke. AI and LI patients should be highly suspected for early onset of ischemic stroke,and the plaque characteristics of AI/LI may be used as reference conditions to distinguish AI/LI from CI patients.
作者
刘志
李改
李冰
刘洋
LIU Zhi;LI Gai;LI Bing;LIU Yang(Department of Neurology,Central Hospital of Jilin City,Jilin 132011,China;Department of Ultrosound,Affiliated Hospital of Jilin Medical Col-lege,Jilin 132013,China;Laboratory of Medical Function,School of Basic Medical Sciences,Beihua University,Jilin 132021,China;Department of Pathophysiology,School of Basic Medical Sciences,Beihua University,Jilin 132021,China)
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2018年第8期717-719,723,共4页
Journal of China Medical University
基金
吉林省教育厅"十二五"科学技术研究计划(2015-164)
吉林市医疗卫生指导性计划(201737166)
