【摘要】 目的探讨颈动脉粥样硬化(CAS)在急性脑梗死(ACI)发病机制中的作用以及可能的病理机制。方法对年龄匹配的86例ACI患者和88例以冠心病为主的非脑梗死(NS)患者进行颈动脉彩色多普勒检查,分析2组患者各项动脉粥样硬化危险因子与超声波检查结果之间相关关系。为了进一步分析颈动脉斑块形成的可能成因,根据颈动脉斑块的有、无将所有患者重新分为斑块组和无斑块组,并比较2组各项观察指标的差异。结果①ACI组的C-反应蛋白(CRP)、低密度脂蛋白(LDL)和颈动脉内膜-中层厚度(IMT)明显高于NS组(分别为P<0.01、<0.05、<0.05);ACI组的颈动脉斑块发生率(P<0.01)和颈动脉狭窄发生率(P<0.05)也显著高于NS组。②斑块组的年龄(P<0.01)、高血压(P<0.01)、糖尿病(P<0.05)和CRP水平(P<0.05)均明显高于无斑块组。③IMT的增厚主要与年龄相关(r=0.124,P<0.01);高血压患者的颈总动脉(P<0.01)和颈内动脉(P<0.01)的IMT也明显厚于非高血压患者。结论CAS在ACI的发生机制中起着重要的作用,其本身的病理机制可能有别于全身其他部位的动脉粥样硬化。更多还原

【Abstract】 Objective To investigate the roles of carotid atherosclerosis (CAS) in the pathogenesis of acute cerebral infarction (ACI) and its possible mechanism.Methods 86 ACI patients and 88 age-matched non-stroke cases(NS) were checked by an invasive color ultrasonography on the carotid arteries.The common risk factors of atherosclerosis (AS) were associated with ultrasonic findings.All cases were regrouped into the plaque group and non-plaque group according to the ultrasonic presence and absence of plaque,and these AS risk factors were reanalyzed to further investigate the possible mechanism of plaques.Results ①Compared with the NS group,a significantly increased level of C reactive protein (CRP) (P<0.01) and LDL (P<0.05),and a thicker intima-media thickness (IMT) of carotid artery (P<0.05) were found in the ACI group with the higher occurrence rates of plaques (P<0.01) and narrowed carotid arteries (P<0.05).②Age (P<0.01),hypertension (P<0.01),diabetes (P<0.05) and CRP levels (P<0.05) were higher in the plaque group than those in the non-plaque group.③IMT increased mainly with age (r=0.124,P<0.01).The IMT of carotid artery(P<0.01) and intracarotid artery (P<0.01) was thicker in patients with hypertension than in non-hypertension patients.Conclusion CAS may play an important role in ACI,its pathogenesis mechanism might be different from AS in other parts of body.更多还原