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脑血管病是世界上发病率与死亡率最高的三大疾病之一,在我国各类疾病中居第2位,颅内外动脉粥样硬化性狭窄是缺血性脑血管病的最重要的病因和危险因素,动脉粥样硬化(Atherosclerosis,AS)本身是一种慢性进展性累及全身动脉的疾病,病变最早可从儿童期发生,可见到脂纹、纤维斑块和混杂斑块等各种病理改变,并可见到粥样溃疡和局部血栓形成,可有钙化和斑块内出血[1]。由于上述病理改变,可导致同侧脑组织低灌注而产生一过性脑缺血症状,或者由于易损斑块的小栓子脱落引发脑梗死。当颈动脉狭窄伴有视网膜或脑缺血症状时,称为有症状颈动脉狭窄;具有上述颈动脉狭窄病理变化,而尚未发生临床症状的颈动脉狭窄称之为无症状性颈动脉狭窄。随着科学技术的发展,临床工作中颅内外血管检查已非常普遍[2]。颅内外动脉狭窄的病因及治疗已成为当前研究的焦点。本文就颅内外动脉粥样硬化的病因及发病机制、颅内外动脉狭窄的实验检查、相关危险因素及治疗作一综述。
Cerebrovascular disease is one of the three diseases with the highest morbidity and mortality rate in the world, ranking second in all kinds of diseases in our country. Intracranial and extracranial atherosclerotic stenosis is the most important cause of ischemic cerebrovascular disease and Risk factors, Atherosclerosis (AS) itself is a chronic progressive disease involving the systemic arteries, the earliest lesions can occur from childhood, you can see the lipid pattern, fibrous plaque and mixed plaque and other pathological changes , And can be seen atherothrombosis and local thrombosis, calcification and plaque may have bleeding [1]. Due to the pathological changes, can lead to ipsilateral brain tissue hypoperfusion caused by transient cerebral ischemia, or due to the fragility of small emboli shedding lead to cerebral infarction. When carotid artery stenosis with retinal or cerebral ischemic symptoms, known as symptomatic carotid stenosis; with the pathological changes of carotid stenosis, and no clinical symptoms of carotid stenosis called asymptomatic carotid stenosis. With the development of science and technology, intracranial and extracranial vascular examination in clinical work has been very common [2]. The causes and treatment of intracranial and extracranial arterial stenosis have become the focus of current research. This article reviews the etiology and pathogenesis of extracranial and extracranial atherosclerosis, experimental tests of intracranial and extracranial arterial stenosis, related risk factors and treatment.