初發及復發性前循環缺血性腦卒中患者頸動脈粥樣硬化斑塊對比研究

王安寧 王洪海 鐘池 許曉偉 邢國平

[摘要] 目的 研究初發及復發性前循環缺血性腦卒中患者頸動脈粥樣硬化斑塊的差異性。 方法 篩選符合條件的98例前循環初發性腦梗死（初發組）、132例前循環復發性腦梗死（復發組）進入該研究，采用彩色多普勒血流成像技術觀察入組患者頸動脈粥樣硬化斑塊的數目及部位，記錄斑塊性質。 結果 復發性前循環腦梗死組患者斑塊發生率及血管狹窄發生率明顯高于初發性前循環腦梗死組（95.5%和50.1%比86.7%和21.4%，P=0.000），復發性腦梗死組斑塊性質以為不穩定性斑塊為主（77.3%）。 結論 前循環復發性腦梗死與頸動脈不穩定性粥樣斑塊及血管狹窄相關，不穩定斑塊及頸動脈狹窄可能是引起前循環復發性腦梗死的危險因素之一。

[關鍵詞] 頸動脈斑塊；初發腦梗死；復發性腦梗死

[中圖分類號] R4 [文獻標識碼] A [文章編號] 1674-0742（2015）05（b）-0036-03

Analysis of Atherosclerotic Plaque Between Initial and Recurrent Cerebral Infarction in Carotid Artery System

WANG An-ning，WANG Hong-hai，ZHONG Chi，XU Xiao-wei，XING Guo-ping

Department of Neurology，Weifang People's Hospital， Weifang， Shandong Province， 261041 China

[Abstract] Objective To compare the difference of atherosclerotic plaque between initial and recurrent cerebral infarction in carotid artery system. Methods 98 cases of first cerebral infarction in carotid artery system and 132 cases of recurrent cerebral infarction in carotid artery system were included in the study. The number and distribution of the atherosclerotic plaque were collected with color Doppler imaging. The character of atherosclerotic plaque was analyzed. Results The incidence of carotid plaque and the rate of artery stenosis of blood vessels in the recurrent group were higher than those in the first cerebral infarction group（95.5% and 50.1% vs 86.7% and 21.4%，P=0.000），and most of atherosclerotic plaques in recurrent cerebral infarction group were vulnerable plaques（77.3%）.Conclusion Recurrent cerebral infarction in carotid artery system is related to unstable plaque and the degree of stenosis which may be one cause of recurrent cerebral infarction in carotid artery system.

[Key words] Carotid Plaque； First ischemic stroke；Recurrent Ischemic Stroke

急性缺血性卒中目前已成為危害人類健康的常見病和多發病，其致殘率高，復發率高[1]，已經成為目前造成我國居民致殘的第一原因和導致我國居民死亡的第二位原因[2]。對復發性缺血性腦血管病的危險因素進行探討，對腦卒中的二級預防具有重要意義。頸動脈粥樣硬化在前循環缺血性卒中的發病過程中扮演了重要角色。該研究通過對比前循環初發性及復發性缺血性腦卒中患者的頸動脈硬化斑塊數目及性質，計算血管狹窄率，將兩者進行對比研究，以期望給缺血性腦血管病的二級預防提供理論依據，現報道如下?！?br>