联合颈部血管彩超和DSA评估动脉粥样斑块和脑梗死关联性意义.doc

联合颈部血管彩超和DSA评估动脉粥样斑块和脑梗死关联性意义 　　【摘要】 目的 探讨颈部血管彩超及DSA在动脉粥样硬化性脑梗死中的临床应用价值。方法 以120例动脉粥样硬化性脑梗死患者为患者组， 75例未发生脑梗死患者为对照组， 经颈部血管彩超及DSA检查。结果 二者颈动脉粥样斑块发生率差异有统计学意义， 120例脑梗死患者中， 颈动脉及椎动脉粥样斑块发生率为81%， 对照组仅有13%。颈动脉斑块最常见颈总动脉分叉处， 其次为颈动脉颅内段， 椎动脉以起始段多见， 其次为基底动脉分布， 多以病灶同侧多见， 易形成血管狭窄及血流动力学改变。结论 颈动脉粥样硬化与脑梗死的发病存在关联性：联合颈部血管彩超与DSA能早期准确发现颈动脉粥样硬化斑块及了解斑块的狭窄率， 对预防或治疗脑梗死的发生有重要意义。 【关键词】 颈部血管彩超；DSA；动脉粥样硬化性脑梗死；颈动脉狭窄 Remark on correlation of atherosclerosis and cerebral infarction by combining double carotid chromatic ultrasonic（DCCU） with DSA FANG Bo. Department of Neurology， People’s Hospital of Lu’an， Lu’an 237005， China 【Abstract】 Objective To assess the clinical value of DCCU and DSA in atherosclerotic cerebral infarction. Methods A study was conducted involving 120 patients with atherosclerotic cerebral infarction as patient groups and 75 patients without cerebral infarction as control groups undergoing DCCU and DSA. Results There are distinct differences in rates of carotid atherosclerosis plaque. The occurrence rates of carotid and vertebral artery atherosclerotic plaques in patient groups and control group were respectively 81% and 13%. Carotid atherosclerotic plaques were mostly located at the bifurcation of the carotid artery， and occurred at the same side of stroke focus， which often led to vascular stenosis and hemodynamic change. Conclusion There exists the correlation between carotid atherosclerosis and cerebral infarction： it is of vital importance to combine DCCU with DSA to find carotid atherosclerosis at an early stage and understand vascular stenosis rate to prevent or treat the occurrence of cerebral infarction. 【Key words】 Double carotid chromatic ultrasonic（DCCU）； DSA； Atherosclerotic cerebral infarction； Carotid stenosis 缺血性脑血管病是我国常见致死性疾病之一， 各种原因导致的颈动脉粥样硬化斑块和狭窄是中国人缺血性卒中的主要病理基础， 而积极预防和干预是降低脑卒中的发病率， 改善预后的关键。目前临床有多种方法如数字减影血管造影（DSA）， 颈部血管彩超及CTA、MRA、TCD等血管检查都可以在不同程度上评价缺血性卒中供血动脉的硬化斑块及狭窄， 闭塞情况， 作者采用DSA联合颈部血管彩超能准确探讨颈部及颅内外动脉斑块的特征， 以及不同性质斑块与临床表现的关系， 从而达到准确的积极的预防治疗。 1 资