【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,P<0.05),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,P<0.05),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。更多还原

【Abstract】 Objective The aim of this study was using the contrast-enhanced ultrasound to compare the correlation between the carotid artery stenosis plaques neovascularization and the ischemic cerebrovascular events. Method 24 patients with ICA stenosis( > 70%) were chosen. 45 arterial stenosis plaques of these patients were taken as subjects. CEUS was used to detect the plaques’ neovascularization. In the meantime the head MRI image,the serum LDL and TG in these patients were checked. Then the NIHSS scores were calculated before and after treatments. Last the relationship of IA stenosis plaques neovascularization enhanced Intensity with patients’ clinical symptoms、ipsilateral infarct of brain and lipid were analyzed. Result( 1) There was marked statistical significance in the comparison of patients having clinical symptoms with patients having no clinical symptoms about the neovascularization enhanced intensity( 42. 61 ± 13. 63 vs. 18. 29± 6. 68,P < 0. 05);( 2) There was marked statistical significance in the comparison of patients having ipsilateral narrow infarction with patients having no ipsilateral narrow infarction about the neovascularization enhanced intensity( 34. 66 ± 13. 67 vs. 20. 36 ± 6. 53,P < 0. 05);( 3) There was no statistical significance of the ICA stenosis plaque neovascularization with the history of high blood pressure or type 2 diabetes mellitus and LDL、TG level;( 4) The ICA stenosis plaque neovascularization had no marked correlation with the NIHSS level before treatment and the difference between before and after treatment. Conclusion( 1) The patients with clinical symptoms have a much higher neovascularization enhanced Intensity of the ICA stenosis plaques than the no clinical symptoms patients;( 2) There is correlation between ICA stenosis ipsilateral brain ischemia event and the stenosis plaques neovascularization;( 3) There isn’t significant correlation between the ICA stenosis plaque neovascularization and the history of high blood pressure or type 2 diabetes mellitus and LDL、TG level;( 4)The ICA stenosis plaque neovascularization enhanced Intensity has no significant difference with the pretreatment NIHSS level,it hasn’t significant correlation with the subtraction between pretreatment and posttreatment.更多还原