【摘要】：目的應(yīng)用超聲造影技術(shù)(CEUS)探討頸動(dòng)脈狹窄斑塊性質(zhì)與缺血性腦血管事件的關(guān)系。方法選擇頸內(nèi)動(dòng)脈狹窄(70%)的患者24例,其中納入狹窄處斑塊45個(gè)作為研究對(duì)象。超聲造影檢測斑塊內(nèi)新生血管化情況,行頭部MRI檢查明確診斷,檢測患者血清中甘油三酯、低密度脂蛋白等化驗(yàn)指標(biāo),并對(duì)其治療前后的狀態(tài)行NIHSS評(píng)分。分析頸內(nèi)動(dòng)脈狹窄處斑塊內(nèi)新生血管的增強(qiáng)程度與患者的臨床癥狀、同側(cè)腦梗死灶、血脂及預(yù)后等情況的關(guān)系。結(jié)果(1)有臨床癥狀和無臨床癥狀兩組斑塊內(nèi)新生血管造影劑的增強(qiáng)強(qiáng)度比較(42.61±13.63VS 18.29±6.68,P0.05),差異有顯著統(tǒng)計(jì)學(xué)意義;(2)ICA狹窄同側(cè)腦梗死組與非腦梗死組狹窄處斑塊內(nèi)的新生血管增強(qiáng)強(qiáng)度比較(34.66±13.67 VS 20.36±6.53,P0.05),差異有顯著統(tǒng)計(jì)學(xué)意義;(3)ICA狹窄處斑塊內(nèi)新生血管增強(qiáng)強(qiáng)度與并發(fā)高血壓、糖尿病及血脂水平無統(tǒng)計(jì)學(xué)意義;(4)ICA狹窄處斑塊內(nèi)新生血管增強(qiáng)強(qiáng)度與治療前NIHSS評(píng)分及治療前后的NIHSS評(píng)分差值無明顯相關(guān)性。結(jié)論 (1)有臨床癥狀組ICA狹窄處斑塊的新生血管增強(qiáng)強(qiáng)度明顯高于無臨床癥狀組;(2)ICA狹窄同側(cè)的缺血性腦血管事件的發(fā)生與其狹窄處斑塊內(nèi)新生血管增強(qiáng)強(qiáng)度有相關(guān)性;(3)ICA狹窄處斑塊內(nèi)的新生血管增強(qiáng)強(qiáng)度與其高血壓病病史、2型糖尿病病史、LDL和TG水平無明顯相關(guān)性;(4)ICA狹窄處斑塊內(nèi)新生血管增強(qiáng)強(qiáng)度與治療前NIHSS評(píng)分及治療前后的NIHSS評(píng)分差值無明顯相關(guān)性。
[Abstract]:Objective to investigate the relationship between carotid artery stenosis plaque and ischemic cerebrovascular events by contrast-enhanced echocardiography (CEUS). Methods A total of 24 patients with internal carotid artery stenosis (70%) were included in the study. Contrast-enhanced ultrasonography was used to detect angiogenesis in plaque, head MRI was performed to detect the diagnosis, serum triglyceride and low density lipoprotein were detected, and NIHSS scores were evaluated before and after treatment. To analyze the relationship between the degree of enhancement of angiogenesis in plaque in stenosis of internal carotid artery and clinical symptoms, ipsilateral cerebral infarction, blood lipids and prognosis. Results (1) the enhancement intensity of neovascularization contrast agent in plaque between the two groups with and without clinical symptoms (42.61 鹵13.63VS 18.29 鹵6.68) was significantly higher than that in the control group (P 0.05). (2) the neovascularization of plaque in the ipsilateral cerebral infarction group with and without the ICA stenosis was significantly different from that in the non-cerebral infarction group. The intensity of vessel enhancement was significantly higher than that of vessel enhancement (34.66 鹵13.67 vs 20.36 鹵6.53, P0.05). (3) the intensity of neovascularization in ICA stenosis was associated with hypertension. (4) there was no significant correlation between the intensity of neovascularization in ICA stenosis and the NIHSS score before and after treatment and the difference of NIHSS score before and after treatment. Conclusion (1) the enhancement intensity of neovascularization in plaque of ICA stenosis is significantly higher than that in group without clinical symptoms, (2) the occurrence of ischemic cerebrovascular events in ipsilateral side of ICA stenosis is correlated with the intensity of neovascularization in stenosed plaque. (3) the enhancement intensity of neovascularization in the plaque of ICA stenosis was not significantly correlated with the history of hypertension and type 2 diabetes mellitus, (4) the intensity of intraplaque neovascularization in ICA stenosis was correlated with NIHSS score before treatment and before treatment. There was no significant correlation between the difference of NIHSS score after operation.
【作者單位】： 北華大學(xué)附屬醫(yī)院神經(jīng)內(nèi)科;柳河鎮(zhèn)中心醫(yī)院內(nèi)科;
【分類號(hào)】：R743.3

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