勁動脈顱外段病變與缺血性腦卒中OCSP分型的關(guān)系
發(fā)布時間：2018-09-03 17:23
【摘要】：目的 探討頸動脈顱外段病變與牛津郡社區(qū)卒中項目（OCSP）分型的關(guān)系。為缺血性腦卒中的個體化治療及二級預(yù)防提供新的切入點(diǎn)和參考依據(jù)。 方法 本研究選取2010年2月至2011年11月在鄭州大學(xué)第一附屬醫(yī)院神經(jīng)內(nèi)科住院的急性缺血性腦卒中患者160例。所有患者發(fā)病一周內(nèi)入院，為首次發(fā)病或再次發(fā)病但此前無神經(jīng)功能缺損。按照牛津郡社區(qū)卒中項目（OCSP）的分型標(biāo)準(zhǔn)根據(jù)臨床表現(xiàn)對所有缺血性腦卒中患者進(jìn)行腦梗死亞型分型，并分為A、B、C三組。A組包括完全前循環(huán)腦梗死（TACI）9例和部分前循環(huán)腦梗死（PACI）67例，共76例；B組包括后循環(huán)腦梗死患者(POCI)40例；44例腔隙性腦梗死(LACI)患者歸入C組。通過彩色多普勒超聲觀察所有缺血性腦卒中患者頸動脈顱外段動脈粥樣硬化病變的特點(diǎn)，記錄頸動脈顱外段狹窄程度，頸動脈粥樣硬化斑塊的發(fā)生部位、形態(tài)、回聲強(qiáng)度、質(zhì)地等情況，并對所得數(shù)據(jù)在各組間進(jìn)行比較分析。采用SPSS17.0軟件進(jìn)行統(tǒng)計學(xué)分析。 結(jié)果 1．160例缺血性腦卒中患者中，頸動脈粥樣硬化斑塊檢出率為68.1%，頸動脈中度及中度以上狹窄發(fā)生率為12.5%。 2．A組頸動脈粥樣硬化斑塊檢出率為77.6%、不穩(wěn)定斑塊檢出率為59.1%，高于B組和C組（P0.05）。B組與C組比較差異無統(tǒng)計學(xué)意義（P0.05）。 3．頸動脈粥樣硬化斑塊好發(fā)于頸總動脈分叉處，，A、B、C三組比較差異無統(tǒng)計學(xué)意義（P0.05）。 4．160例缺血性腦卒中患者中，共檢出299枚動脈粥樣硬化斑塊。A組患者檢出的不穩(wěn)定斑塊數(shù)目明顯多于B組（P0.01）、C組(P0.05)。B組與C組比較差異無統(tǒng)計學(xué)意義（P0.05）。 5．A組檢出四個及以上動脈粥樣硬化斑塊的有24例（31.6%）高于B組和C組，（P0.05）。B組與C組比較差異無統(tǒng)計學(xué)意義（P0.05）。 6．A、B、C三組頸動脈狹窄發(fā)生率分別為59.2%、42.5%、43.2%，三組比較差異無統(tǒng)計學(xué)意義（P0.05）。頸動脈中度及中度以上狹窄發(fā)生率A組為22.4%高于B組的2.5%（P0.01）和C組的4.5％（P0.05）。B組與C組比較差異無統(tǒng)計學(xué)意義（P0.05）。 結(jié)論 1．缺血性腦卒中患者頸動脈顱外段粥樣硬化病變的特點(diǎn)為動脈粥樣硬化斑塊發(fā)生率高，而嚴(yán)重狹窄發(fā)生率相對較低。 2．OCSP分型不同亞型的頸動脈顱外段動脈粥樣硬化病變特點(diǎn)不同。OCSP分型各亞型中，頸動脈粥樣硬化斑塊，尤其是不穩(wěn)定斑塊與PACI和TACI的發(fā)生有一定相關(guān)性； 3．OCSP分型對嚴(yán)重頸動脈顱外段狹窄有一定預(yù)測價值，PACI和TACI患者可能存在嚴(yán)重的頸動脈顱外段狹窄。
[Abstract]:Objective to investigate the relationship between extracranial carotid artery disease and (OCSP) classification of Oxfordshire community stroke project. To provide a new entry point and reference for individualized treatment and secondary prevention of ischemic stroke. Methods from February 2010 to November 2011, 160 patients with acute ischemic stroke were enrolled in Department of Neurology, first affiliated Hospital of Zhengzhou University. All patients were admitted to hospital within one week of onset. According to the (OCSP) classification criteria of Oxfordshire Community Stroke Project, all ischemic stroke patients were subdivided into three groups according to their clinical manifestations. Group A was divided into three groups, including 9 patients with complete anterior circulation cerebral infarction (TACI) and 67 patients with partial anterior circulation infarction (PACI). A total of 76 patients in Group B included 40 patients with posterior circulatory cerebral infarction (POCI) and 44 patients with lacunar infarction (LACI). The characteristics of extracranial carotid artery atherosclerosis in all patients with ischemic stroke were observed by color Doppler ultrasound. The degree of extracranial carotid artery stenosis, the location, morphology and echo intensity of carotid atherosclerotic plaque were recorded. Texture and so on, and the data in each group were compared and analyzed. SPSS17.0 software was used for statistical analysis. Results among 1.160 patients with ischemic stroke, The detection rate of carotid atherosclerotic plaque and carotid artery stenosis were 68.1 and 12.5 respectively. 2. In group A, the detection rate of carotid atherosclerotic plaque was 77.6, and the detection rate of unstable plaque was 59.1, which was higher than that in group B and C. (P0.05). There was no significant difference between group B and group C (P0.05). 3. There was no significant difference among the three groups in carotid atherosclerotic plaques at the common carotid artery bifurcation (P0.05). Among 4.160 patients with ischemic stroke, there was no significant difference among the three groups (P0.05). A total of 299 atherosclerotic plaques were detected in group A. the number of unstable plaques detected in group A was significantly higher than that in group B (P0.01). There was no significant difference between group B and group C. there was no significant difference between group B and group C. 5. Group A detected four or more atherosclerotic plaques. 24 cases (31.6%) of sclerosing plaque were higher than B group and C group (P0.05). There was no significant difference between group B and C (P0.05). 6. The incidence of carotid artery stenosis in group C was 59.2% (P 0.05). There was no significant difference among the three groups (P0.05). The incidence of moderate and moderate carotid artery stenosis in group A was 22.4% higher than that in group B (2.5%, P0.01) and group C (4.5%, P0.05). There was no significant difference between group B and group C (P0.05). Conclusion 1. The characteristics of extracranial carotid atherosclerosis in patients with ischemic stroke are the high incidence of atherosclerotic plaques. However, the incidence of severe stenosis was relatively low. There were different characteristics of extracranial carotid atherosclerotic lesions in different subtypes of 2.OCSP. In particular, unstable plaques were associated with the occurrence of PACI and TACI, and 3.OCSP classification was a predictor of severe extracranial carotid stenosis. PACI-and TACI patients may have severe extracranial carotid stenosis.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.3
[Abstract]:Objective to investigate the relationship between extracranial carotid artery disease and (OCSP) classification of Oxfordshire community stroke project. To provide a new entry point and reference for individualized treatment and secondary prevention of ischemic stroke. Methods from February 2010 to November 2011, 160 patients with acute ischemic stroke were enrolled in Department of Neurology, first affiliated Hospital of Zhengzhou University. All patients were admitted to hospital within one week of onset. According to the (OCSP) classification criteria of Oxfordshire Community Stroke Project, all ischemic stroke patients were subdivided into three groups according to their clinical manifestations. Group A was divided into three groups, including 9 patients with complete anterior circulation cerebral infarction (TACI) and 67 patients with partial anterior circulation infarction (PACI). A total of 76 patients in Group B included 40 patients with posterior circulatory cerebral infarction (POCI) and 44 patients with lacunar infarction (LACI). The characteristics of extracranial carotid artery atherosclerosis in all patients with ischemic stroke were observed by color Doppler ultrasound. The degree of extracranial carotid artery stenosis, the location, morphology and echo intensity of carotid atherosclerotic plaque were recorded. Texture and so on, and the data in each group were compared and analyzed. SPSS17.0 software was used for statistical analysis. Results among 1.160 patients with ischemic stroke, The detection rate of carotid atherosclerotic plaque and carotid artery stenosis were 68.1 and 12.5 respectively. 2. In group A, the detection rate of carotid atherosclerotic plaque was 77.6, and the detection rate of unstable plaque was 59.1, which was higher than that in group B and C. (P0.05). There was no significant difference between group B and group C (P0.05). 3. There was no significant difference among the three groups in carotid atherosclerotic plaques at the common carotid artery bifurcation (P0.05). Among 4.160 patients with ischemic stroke, there was no significant difference among the three groups (P0.05). A total of 299 atherosclerotic plaques were detected in group A. the number of unstable plaques detected in group A was significantly higher than that in group B (P0.01). There was no significant difference between group B and group C. there was no significant difference between group B and group C. 5. Group A detected four or more atherosclerotic plaques. 24 cases (31.6%) of sclerosing plaque were higher than B group and C group (P0.05). There was no significant difference between group B and C (P0.05). 6. The incidence of carotid artery stenosis in group C was 59.2% (P 0.05). There was no significant difference among the three groups (P0.05). The incidence of moderate and moderate carotid artery stenosis in group A was 22.4% higher than that in group B (2.5%, P0.01) and group C (4.5%, P0.05). There was no significant difference between group B and group C (P0.05). Conclusion 1. The characteristics of extracranial carotid atherosclerosis in patients with ischemic stroke are the high incidence of atherosclerotic plaques. However, the incidence of severe stenosis was relatively low. There were different characteristics of extracranial carotid atherosclerotic lesions in different subtypes of 2.OCSP. In particular, unstable plaques were associated with the occurrence of PACI and TACI, and 3.OCSP classification was a predictor of severe extracranial carotid stenosis. PACI-and TACI patients may have severe extracranial carotid stenosis.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.3
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