CAJ | 학술논문

目的：分析老年脑梗死与颈动脉粥样硬化斑块的相关性及预后的关系。方法选取100例老年脑梗死患者作为观察组和100例同期非脑梗死患者作为对照组，观察和比较2组颈动脉粥样硬化斑块情况、治疗前和治疗3个月、6个月后神经功能缺损评分（NIHSS评分）和日常生活活动能力评分（Barthel指数评分）。结果2组颈动脉粥样硬化斑块检出率分别为86％和17％，观察组显著高于对照组（ P＜0.05），观察组软斑和混合斑的比例显著高于对照组（ P＜0.05），无斑块比例显著低于对照组（P＜0.05）；重型患者中有软斑和混合斑的比例显著高于中型患者（P＜0.05），中型患者显著高于轻型患者（P＜0.05）；轻型患者中无斑块和有硬斑患者比例显著高于中型和重型患者（ P＜0.05）；有软斑和混合斑患者治疗前和治疗后3个月、6个月的NIHSS评分显著高于有硬斑患者（P＜0.05），有硬斑患者治疗前和治疗后3个月、6个月的NIHSS评分显著高于无斑块患者（P＜0.05），有硬斑和无斑块患者在治疗3个月、6个月的Barthel指数评分显著高于有软斑和混合斑的患者（P＜0.05）。结论颈动脉粥样硬化斑块的形成是与老年脑梗死发病具有相关性的危险因素，颈动脉粥样硬化斑块的类型与患者的病情具有相关性，有软斑和混合斑患者的神经功能损害和生活能力缺失症状更加严重、预后情况更差，有硬班和无斑块患者的神经功能损害症状较轻，预后情况较好。
목적：분석노년뇌경사여경동맥죽양경화반괴적상관성급예후적관계。방법선취100례노년뇌경사환자작위관찰조화100례동기비뇌경사환자작위대조조，관찰화비교2조경동맥죽양경화반괴정황、치료전화치료3개월、6개월후신경공능결손평분（NIHSS평분）화일상생활활동능력평분（Barthel지수평분）。결과2조경동맥죽양경화반괴검출솔분별위86％화17％，관찰조현저고우대조조（ P＜0.05），관찰조연반화혼합반적비례현저고우대조조（ P＜0.05），무반괴비례현저저우대조조（P＜0.05）；중형환자중유연반화혼합반적비례현저고우중형환자（P＜0.05），중형환자현저고우경형환자（P＜0.05）；경형환자중무반괴화유경반환자비례현저고우중형화중형환자（ P＜0.05）；유연반화혼합반환자치료전화치료후3개월、6개월적NIHSS평분현저고우유경반환자（P＜0.05），유경반환자치료전화치료후3개월、6개월적NIHSS평분현저고우무반괴환자（P＜0.05），유경반화무반괴환자재치료3개월、6개월적Barthel지수평분현저고우유연반화혼합반적환자（P＜0.05）。결론경동맥죽양경화반괴적형성시여노년뇌경사발병구유상관성적위험인소，경동맥죽양경화반괴적류형여환자적병정구유상관성，유연반화혼합반환자적신경공능손해화생활능력결실증상경가엄중、예후정황경차，유경반화무반괴환자적신경공능손해증상교경，예후정황교호。
Objective To investigate the correlation and prognosis between the elderly patients with cerebral infarction and the carotid atherosclerosis plaque. Methods 100 cases of elderly patients with cerebral infarction were selected as the observa-tion group and 100 cases of elderly patients without cerebral infarction were selected as the control group. The carotid athero-sclerosis plaque ,neural function defect score (NIHSS score) and activities of daily living score (Barthel index score) were ob-served and compared before treatment and after treatment at the 3rd ,6th month. Results The detection rate of carotid athero-sclerosis plaque was 86% in observation group ang 17% in control group.There was mainly soft plaque or mixed plaque in the observation group ,which was higher than that in the control group. Heavy patients were given priority to soft and mixed plaque ,and light patients were given priority to with no plaque and hard spot. The NIHSS scores of patients with soft and mixed plaque were higher than these of patients with hard spot and the NIHSS and Barthel index scores of patients with hard spot were higher than these of patients with no plaque. Conclusion The carotid artery atherosclerotic plaque is a risk factor of elderly cerebral infarction. The nerve function impairment and life ability deficits of patients with soft or mixed plaque have more serious symptoms and prognosis than patients with no plaque and hard spot.