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目的观察症状性和无症状性颈内动脉狭窄的患者大脑中动脉微栓子信号(microembolic sig-nals,MES)阳性率及MES计数的变化,研究微栓子与临床症状和颈内动脉狭窄程度的关系。方法选取症状性颈内动脉狭窄患者26例,无症状性颈内动脉狭窄患者20例及正常对照组30例;症状性颈内动脉狭窄组又分为短暂性脑缺血发作(transient ischemic attack,TIA)组(12例)和脑梗死组(14例);症状性和无症状性颈内动脉狭窄的患者均行DSA或CTA检查,并对颈内动脉狭窄程度进行分级;所有颈内动脉狭窄的患者均对颈内动脉狭窄同侧的大脑中动脉进行MES监测,正常对照组则对双侧大脑中动脉进行MES监测。结果有症状和无症状颈内动脉狭窄组的MES阳性率高于正常对照组(P<0.01);有症状颈内动脉狭窄组MES阳性率较无症状组高(P<0.05);TIA组和脑梗死组比较,MES阳性率无显著性差异(P>0.05);症状性和无症状性颈内动脉狭窄患者,轻、中、重度狭窄三组的MES阳性率比较均有显著性差异(P<0.05);MES阳性患者MES计数与颈内动脉狭窄程度呈正相关(r=0.9155,P<0.01)。结论 MES多见在颈内动脉狭窄患者,特别是症状性颈内动脉狭窄的患者,是缺血性脑血管疾病发生的高危因素。
Objective To observe the changes of the positive rate of MES and the number of MES in patients with symptomatic and asymptomatic carotid artery stenosis and to investigate the correlation between the severity of clinical symptoms and the severity of carotid artery stenosis with microembolic sig-nals Relationship. Methods Twenty-six patients with symptomatic internal carotid artery stenosis, 20 patients with asymptomatic internal carotid artery stenosis and 30 normal controls were included in the study. Patients with symptomatic carotid artery stenosis were divided into transient ischemic attack TIA group (12 cases) and cerebral infarction group (14 cases); symptomatic and asymptomatic patients with internal carotid artery stenosis were performed DSA or CTA examination, and the degree of internal carotid artery stenosis grading; all internal carotid artery stenosis Of patients had MES monitoring of the ipsilateral middle cerebral artery in ICA, while MES monitoring of bilateral middle cerebral artery in the control group. Results The positive rate of MES in symptomatic and asymptomatic carotid stenosis group was higher than that in normal control group (P <0.01). The positive rate of MES in symptomatic carotid artery stenosis group was higher than that in asymptomatic group (P <0.05) There was no significant difference in the positive rate of MES in cerebral infarction group (P> 0.05). The positive rates of MES in mild, moderate and severe stenosis group were significantly different between symptomatic and asymptomatic patients with internal carotid artery stenosis (P <0.05). There was a positive correlation between MES count and carotid artery stenosis in MES-positive patients (r = 0.9155, P <0.01). Conclusion MES more common in patients with carotid artery stenosis, especially in patients with symptomatic carotid artery stenosis, is a risk factor for ischemic cerebrovascular disease.