颈动脉狭窄斑块性质与缺血性脑血管事件关系的研究

发布时间：2018-08-18 12:42

【摘要】：目的应用超声造影技术(CEUS)探讨颈动脉狭窄斑块性质与缺血性脑血管事件的关系。方法选择颈内动脉狭窄(70%)的患者24例,其中纳入狭窄处斑块45个作为研究对象。超声造影检测斑块内新生血管化情况,行头部MRI检查明确诊断,检测患者血清中甘油三酯、低密度脂蛋白等化验指标,并对其治疗前后的状态行NIHSS评分。分析颈内动脉狭窄处斑块内新生血管的增强程度与患者的临床症状、同侧脑梗死灶、血脂及预后等情况的关系。结果(1)有临床症状和无临床症状两组斑块内新生血管造影剂的增强强度比较(42.61±13.63VS 18.29±6.68,P0.05),差异有显著统计学意义;(2)ICA狭窄同侧脑梗死组与非脑梗死组狭窄处斑块内的新生血管增强强度比较(34.66±13.67 VS 20.36±6.53,P0.05),差异有显著统计学意义;(3)ICA狭窄处斑块内新生血管增强强度与并发高血压、糖尿病及血脂水平无统计学意义;(4)ICA狭窄处斑块内新生血管增强强度与治疗前NIHSS评分及治疗前后的NIHSS评分差值无明显相关性。结论 (1)有临床症状组ICA狭窄处斑块的新生血管增强强度明显高于无临床症状组;(2)ICA狭窄同侧的缺血性脑血管事件的发生与其狭窄处斑块内新生血管增强强度有相关性;(3)ICA狭窄处斑块内的新生血管增强强度与其高血压病病史、2型糖尿病病史、LDL和TG水平无明显相关性;(4)ICA狭窄处斑块内新生血管增强强度与治疗前NIHSS评分及治疗前后的NIHSS评分差值无明显相关性。
[Abstract]:Objective to investigate the relationship between carotid artery stenosis plaque and ischemic cerebrovascular events by contrast-enhanced echocardiography (CEUS). Methods A total of 24 patients with internal carotid artery stenosis (70%) were included in the study. Contrast-enhanced ultrasonography was used to detect angiogenesis in plaque, head MRI was performed to detect the diagnosis, serum triglyceride and low density lipoprotein were detected, and NIHSS scores were evaluated before and after treatment. To analyze the relationship between the degree of enhancement of angiogenesis in plaque in stenosis of internal carotid artery and clinical symptoms, ipsilateral cerebral infarction, blood lipids and prognosis. Results (1) the enhancement intensity of neovascularization contrast agent in plaque between the two groups with and without clinical symptoms (42.61 卤13.63VS 18.29 卤6.68) was significantly higher than that in the control group (P 0.05). (2) the neovascularization of plaque in the ipsilateral cerebral infarction group with and without the ICA stenosis was significantly different from that in the non-cerebral infarction group. The intensity of vessel enhancement was significantly higher than that of vessel enhancement (34.66 卤13.67 vs 20.36 卤6.53, P0.05). (3) the intensity of neovascularization in ICA stenosis was associated with hypertension. (4) there was no significant correlation between the intensity of neovascularization in ICA stenosis and the NIHSS score before and after treatment and the difference of NIHSS score before and after treatment. Conclusion (1) the enhancement intensity of neovascularization in plaque of ICA stenosis is significantly higher than that in group without clinical symptoms, (2) the occurrence of ischemic cerebrovascular events in ipsilateral side of ICA stenosis is correlated with the intensity of neovascularization in stenosed plaque. (3) the enhancement intensity of neovascularization in the plaque of ICA stenosis was not significantly correlated with the history of hypertension and type 2 diabetes mellitus, (4) the intensity of intraplaque neovascularization in ICA stenosis was correlated with NIHSS score before treatment and before treatment. There was no significant correlation between the difference of NIHSS score after operation.
【作者单位】：北华大学附属医院神经内科;柳河镇中心医院内科;
【分类号】：R743.3

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