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目的探讨脑动脉微栓子及颈动脉粥样硬化斑块与急性脑梗死的关系。方法选取2014—2015年梅州市人民医院神经内科收治的急性脑梗死患者300例,根据颈动脉超声检查结果分为有斑块组100例和无斑块组200例。比较两组患者生化指标、血管危险因素,检测两组患者脑动脉微栓子及颈动脉粥样硬化斑块情况。结果有斑块组患者糖尿病、高血压、吸烟、高总胆固醇(TC)血症、高低密度脂蛋白胆固醇(LDL-C)血症、低高密度脂蛋白胆固醇(HDL-C)血症发生率均高于无斑块组(P<0.05);两组患者高三酰甘油(TG)血症发生率比较,差异无统计学意义(P>0.05)。有斑块组患者脑动脉微栓子阳性率及检出率均高于无斑块组(P<0.05)。不稳定性斑块患者脑动脉微栓子阳性率高于稳定性斑块患者(P<0.05)。结论颈动脉粥样硬化患者脑动脉微栓子检出率较高,且不稳定性粥样硬化斑块是脑动脉微栓子的主要来源,脑动脉微栓子及颈动脉粥样硬化斑块与急性脑梗死密切相关。
Objective To investigate the relationship between cerebral arterial micro-emboli and carotid atherosclerosis plaques and acute cerebral infarction. Methods Three hundred patients with acute cerebral infarction who were treated in Department of Neurology, Meizhou People ’s Hospital from 2014 to 2015 were selected and divided into 100 cases with plaque group and 200 cases without plaque group according to the result of carotid artery ultrasonography. Biochemical indexes and vascular risk factors were compared between the two groups, and the cerebral arterial micro-emboli and carotid atherosclerotic plaque in both groups were detected. Results Patients in the plaque group had diabetes, hypertension, smoking, hypercholesterolemia, high and low-density lipoprotein cholesterol (LDL-C), and low-density lipoprotein cholesterol (HDL-C) (P <0.05). There was no significant difference in the incidence of triglyceridemia among the two groups (P> 0.05). The positive rate and the detection rate of cerebral embolus in patients with plaque group were higher than those without plaque group (P <0.05). The positive rate of cerebral arterial micro-emboli in patients with unstable plaque was higher than that in patients with stable plaque (P <0.05). Conclusions The detection rate of cerebral arterial micro-emboli in patients with carotid atherosclerosis is high, and unstable atherosclerotic plaque is the main source of cerebral arterial microemboli. Cerebral arterial micro-emboli and carotid atherosclerotic plaque And acute cerebral infarction are closely related.