中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
13期
24-28
,共5页
卒中%易损斑块%CT血管成像
卒中%易損斑塊%CT血管成像
졸중%역손반괴%CT혈관성상
Stroke%Vulnerable plaque%Computed tomography angiography
目的 利用64排螺旋CT血管成像检测颈动脉粥样硬化斑块,探讨颈动脉易损斑块与进展性脑卒中的相关性.方法 将101例新发缺血性脑卒中患者根据病情的演变分为进展性脑卒中组(32例)和非进展性脑卒中组(69例),分析各组颈动脉粥样硬化斑块的狭窄程度及其易损性并进行统计学分析.结果 进展性脑卒中组重度狭窄或闭塞率为28.1％(9/32),明显高于非进展性脑卒中组的8.7％(6/69),差异有统计学意义(P=0.0ll).进展性脑卒中组的易损斑块率为75.0％(24/32),明显高于非进展性脑卒中组的42.0％ (29/69),差异有统计学意义(P=0.002)；在不同类型的易损斑块(脂质核心、表面不规则、溃疡斑块)中,两组溃疡斑块率比较差异有统计学意义(P=0.016).将年龄、性别、心血管危险因素、狭窄程度、易损斑块等因素与进展性脑卒中进行单因素、多因素Logistic回归分析,显示糖尿病(OR=3.327,95％CI:1.211 ～ 9.145)和易损斑块(OR=3.699,95％CI:1.292～ 10.589)与进展性脑卒中有关.结论 颈动脉易损斑块是进展性脑卒中的独立危险因素.64排螺旋CT血管成像能为确定颈动脉易损斑块提供一定的诊断信息,对临床治疗具有重要指导意义.
目的 利用64排螺鏇CT血管成像檢測頸動脈粥樣硬化斑塊,探討頸動脈易損斑塊與進展性腦卒中的相關性.方法 將101例新髮缺血性腦卒中患者根據病情的縯變分為進展性腦卒中組(32例)和非進展性腦卒中組(69例),分析各組頸動脈粥樣硬化斑塊的狹窄程度及其易損性併進行統計學分析.結果 進展性腦卒中組重度狹窄或閉塞率為28.1％(9/32),明顯高于非進展性腦卒中組的8.7％(6/69),差異有統計學意義(P=0.0ll).進展性腦卒中組的易損斑塊率為75.0％(24/32),明顯高于非進展性腦卒中組的42.0％ (29/69),差異有統計學意義(P=0.002)；在不同類型的易損斑塊(脂質覈心、錶麵不規則、潰瘍斑塊)中,兩組潰瘍斑塊率比較差異有統計學意義(P=0.016).將年齡、性彆、心血管危險因素、狹窄程度、易損斑塊等因素與進展性腦卒中進行單因素、多因素Logistic迴歸分析,顯示糖尿病(OR=3.327,95％CI:1.211 ～ 9.145)和易損斑塊(OR=3.699,95％CI:1.292～ 10.589)與進展性腦卒中有關.結論 頸動脈易損斑塊是進展性腦卒中的獨立危險因素.64排螺鏇CT血管成像能為確定頸動脈易損斑塊提供一定的診斷信息,對臨床治療具有重要指導意義.
목적 이용64배라선CT혈관성상검측경동맥죽양경화반괴,탐토경동맥역손반괴여진전성뇌졸중적상관성.방법 장101례신발결혈성뇌졸중환자근거병정적연변분위진전성뇌졸중조(32례)화비진전성뇌졸중조(69례),분석각조경동맥죽양경화반괴적협착정도급기역손성병진행통계학분석.결과 진전성뇌졸중조중도협착혹폐새솔위28.1％(9/32),명현고우비진전성뇌졸중조적8.7％(6/69),차이유통계학의의(P=0.0ll).진전성뇌졸중조적역손반괴솔위75.0％(24/32),명현고우비진전성뇌졸중조적42.0％ (29/69),차이유통계학의의(P=0.002)；재불동류형적역손반괴(지질핵심、표면불규칙、궤양반괴)중,량조궤양반괴솔비교차이유통계학의의(P=0.016).장년령、성별、심혈관위험인소、협착정도、역손반괴등인소여진전성뇌졸중진행단인소、다인소Logistic회귀분석,현시당뇨병(OR=3.327,95％CI:1.211 ～ 9.145)화역손반괴(OR=3.699,95％CI:1.292～ 10.589)여진전성뇌졸중유관.결론 경동맥역손반괴시진전성뇌졸중적독립위험인소.64배라선CT혈관성상능위학정경동맥역손반괴제공일정적진단신식,대림상치료구유중요지도의의.
Objective To detect the atherosclerotic plaque by 64-slice CT angiography and study the correlation between vulnerable plaque and progressive stroke.Methods One hundred and one patients with cerebral ischemic stroke were divided into progressive stroke group (32 cases) and non-progressive stroke group (69 cases) according to the pathogenetic condition.The stenosis degree and vulnerability of artherosclerotic plaques was recorded and analyzed.Results The percentage of severe or occlusion carotid artery stenosis in progressive stroke group was 28.1％(9/32),which was significantly increased compared with that in non-progressive stroke group [8.7％(6/69)],and there was significant difference (P =0.011).The percentage of vulnerable plaque in progressive stroke group was 75.0％ (24/32),which was significantly increased compared with that in non-progressive stroke group [42.0％ (29/69)],and there was significant difference (P =0.002).There was significant difference in the ulcer plaque between two groups among the different type of vulnerable plaques (lipid core,surface irregularities,ulcers plaque) (P =0.016).Multivariate analysis showed that diabetes mellitus (OR =3.327,95％ CI:1.211-9.145) and vulnerable plaque (OR =3.699,95％ CI:1.292-10.589) was related with progressive stroke.Conclusions Vulnerable plaque and diabetes mellitus are the independent risk factors of progressive stroke.64-slice CT angiography can clear display carotid vulnerable plaque,which is important for clinical treatment.
