论文部分内容阅读
目的探讨经颈二维B型超声观察缺血性脑卒中患者主动脉弓粥样硬化(AAA)与缺血性脑卒中的相关性及临床应用价值。方法采用经颈二维B型超声对2001年1月至2003年5月我科确诊的56例缺血性脑卒中患者的主动脉弓及颈动脉进行检测,同时对所有患者进行头颅CT或MRI检查。结果56例患者中33例(58.93%)发现AAA,46例(82.1%)发现颈动脉粥样硬化病变,同时合并AAA及颈动脉粥样硬化的32例(57.14%)。AAA的患者中脑梗死25例(44.64%),腔隙性脑梗死8例(14.29%),P<0.05;与缺血性脑血管病部分危险因素中年龄、性别、血糖、LDL的关系比较:AAA程度分级Ⅰ、Ⅱ、Ⅲ级,年龄、血糖、LDL呈增高趋势;性别比较,男性AAA阳性度高于女性,P<0.05;AAA与无AAA患者血糖比较,前者高于后者,P<0.05。结论AAA与缺血性脑卒中的危险因素密切相关,是缺血性脑卒中潜在的栓子来源和独立的危险因素。经颈二维B型超声探查56例缺血性脑卒中患者AAA的阳性率为58.9%,可以清楚地显示AAA斑块的形态学特征。该方法简便易操作且患者无痛苦,可广泛应用于临床,适合寻找病因不明的缺血性脑卒中患者潜在的栓子来源,指导服用调脂、抗凝及抗血小板药物的治疗,防止缺血性中风的复发,也适合应用于AAA的流行病学调查,并为缺血性脑血管病预防和治疗方案提供客观检查依据。
Objective To investigate the correlation and clinical value of aortic arch atherosclerosis (AAA) with ischemic stroke in two-dimensional neck B-mode ultrasound in patients with ischemic stroke. Methods The aortic arch and carotid artery of 56 patients with ischemic stroke diagnosed from January 2001 to May 2003 in our hospital were examined by 2D cervical B-mode ultrasound. CT or MRI was performed on all patients at the same time. Results Of the 56 patients, AAA found in 33 patients (58.93%) and carotid atherosclerotic lesions in 46 patients (82.1%). There were also 32 patients (57.14%) with AAA and carotid atherosclerosis. There were 25 cases (44.64%) of middle cerebral infarction and 8 cases of lacunar infarction (14.29%) in AAA patients, P <0.05. Compared with the age, gender, blood glucose and LDL of some risk factors of ischemic cerebrovascular disease : AAA grade grading Ⅰ, Ⅱ, Ⅲ grade, age, blood glucose, LDL showed an increasing trend; gender, male AAA positive than female, P <0.05; AAA and no AAA patients blood glucose, the former is higher than the latter, P <0.05. Conclusions AAA is closely related to the risk factors of ischemic stroke and is a potential source of emboli and an independent risk factor for ischemic stroke. The positive rate of AAA in 56 cases with ischemic stroke was 58.9% by cervical two-dimensional B-mode ultrasound, which can clearly show the morphological features of AAA plaques. The method is simple and easy to operate and patient-free and can be widely used in clinic. It is suitable for finding potential emboli sources of patients with ischemic stroke of unknown etiology, guiding the treatment of taking lipid-lowering, anticoagulant and antiplatelet drugs, and preventing ischemia It is also suitable for epidemiological investigation of AAA and provide an objective basis for the prevention and treatment of ischemic cerebrovascular disease.