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目的研究颈动脉颅外段严重狭窄患者的血管重构与缺血性脑血管病临床表现的关系。资料与方法经多层螺旋CT血管造影(MSCTA)发现颈动脉严重狭窄(≥50%)的患者137例,其中有缺血性脑血管病症状组57例,无症状组80例。分别测量两组患者颈动脉的面积狭窄率(stenosis ratio,SR)、偏心指数(eccentricity index,EI)和重构指数(remodeling index,RI),并比较两组之间的差异。结果有症状组的RI(1.95±0.51)明显高于无症状组(1.57±0.45)(P=0.01),而两组间的SR[有症状组为(68.9±12.7)%,无症状组为(69.4±10.9)%;P=0.56]和EI[有症状组为(0.19±0.13),无症状组为(0.16±0.12);P=0.41]差异无统计学意义。结论有症状患者血管扩张性重构的程度高于无症状患者。
Objective To study the relationship between vascular remodeling and clinical manifestations of ischemic cerebrovascular disease in patients with severe stenosis of extracranial carotid artery. Materials and Methods 137 cases of severe carotid stenosis (≥50%) were found by multi-slice spiral CT angiography (MSCTA), including 57 cases of ischemic cerebrovascular disease and 80 cases of asymptomatic. The carotid artery stenosis ratio (SR), eccentricity index (EI) and remodeling index (RI) were measured in the two groups, and the differences between the two groups were compared. Results The RI of the symptomatic group (1.95 ± 0.51) was significantly higher than that of the asymptomatic group (1.57 ± 0.45) (P = 0.01), but the SR of the symptomatic group was 68.9 ± 12.7% and that of the asymptomatic group was (69.4 ± 10.9)%; P = 0.56] and EI (symptomatic group was (0.19 ± 0.13), asymptomatic group was (0.16 ± 0.12); P = 0.41], the difference was not statistically significant. Conclusion The degree of vasodilatation in symptomatic patients is higher than that in asymptomatic patients.