【摘要】 目的　探讨脑栓塞患者的主动脉弓粥样硬化 (AAA)严重程度、临床意义、栓塞的潜在性及其有关的危险因素 ,进一步了解AAA与颈动脉及心脏疾病的相关性。方法　对 49例脑栓塞患者进行了TCD ,经食道超声心动图 (TEE) ,颈动脉实时超声 ,CT及MRI等检查。AAA分为三级 :轻度、中度、重度或活动性动脉粥样硬化斑块。结果　 31例 (6 3 % )在主动脉弓发现有动脉粥样硬化性病变。其中 7例 (14 1% )呈轻度病理改变 ,9例 (18 4% )呈中度病理改变 ,15例 (30 6 % )呈重度病理改变 ,31例患者中 11例患者无明显的颈内动脉及心脏疾患 ,其主动脉斑块可能是其脑栓塞的主要原因 ;33例患者伴有颈内动脉粥样硬化 (ICAA)改变 ;9例患者伴有心脏疾病 ;高龄及ICAA组AAA发生率明显增高。结论　主动脉弓粥样硬化是脑栓塞的重要潜在性栓塞源更多还原

【Abstract】 Objective The purpose of this study was to determine the prevalence, clinical significance, and embolic potential of thoracic aortic plaque in patients with cerebral emblism; and further study the correlation of aortic plaque with carotid or heart disease. Methods 49 consecutive patients with cerebral embolism were included in this sutdy. The transesophagal echography (TEE) was used to evaluated potential source of emboli in aortic arch and heart, and used duplex for carotid artery. An atherosclerotic lesion of thoracic aorta was defined as normal (0); mild plaque (1); moderate plaque (2); protruding plaque or mobile plaque (3). Results 31(63%) patients showed evidence of AAA; 7(14.1%) patients had mild AAA, 9 (18.4%) patients had moderate AAA and 15(30.6%) patients had severe AAA, among these 15 patients 11 patients did not had neither severe internal carotid arterial atherosclerosis (ICAA) nor carotid embolic disease. There fore, AAA may be the cause of cerebral embolism. 33 patients had ICAA and 9 patients had carotid embolic disease. Age and ICAA had significant correlated with aortic plaque. Conclusions Aortic arch atherosclerosis is an important potential source of cerebral embolic stroke.更多还原