临床神经病学杂志
臨床神經病學雜誌
림상신경병학잡지
Journal of Clinical Neurology
2015年
4期
269-272,280
,共5页
颈动脉粥样硬化斑块%病情%脑梗死复发%多普勒超声
頸動脈粥樣硬化斑塊%病情%腦梗死複髮%多普勒超聲
경동맥죽양경화반괴%병정%뇌경사복발%다보륵초성
carotid atherosclerosis plaque%disease condition%cerebral infarction recurrence%Doppler ultrasound
目的：探讨颈动脉粥样硬化斑块对脑梗死患者病情及复发的影响。方法本研究采用前瞻性队列法设计。应用多普勒超声进行颈动脉斑块探查及定性，将患者分为斑块组和无斑块组。采用NIHSS评分法评估入选患者入院时、入院后第7 d、第14 d神经功能。对患者进行1年的随访，观察脑梗死复发情况。结果根据多普勒超声结果将患者分为斑块组173例（70．3％）和无斑块组73例（29．7％）。与无斑块组比较，斑块组年龄、NIHSS评分及高血压、糖尿病、高脂血症、高纤维蛋白原血症的比率均显著高于无斑块组（P＜0．05～0．01）。在完成随访的患者中，斑块组脑梗死复发39例（24．84％），复发时间为10．12个月；非易损斑块患者脑梗死复发时间为11．82个月，混合斑块患者为10．62个月，易损斑块患者为9．13个月。无斑块组脑梗死复发7例（10．45％），复发时间为11．56个月。斑块组脑梗死复发率显著高于，复发时间显著早于无斑块组（均P＜0．05）。易损斑块患者复发时间显著早于非易损斑块患者（P＝0．034）。结论颈动脉粥样硬化斑块可使急性脑梗死的病情加重，复发率增高，尤其是易损斑块患者。
目的：探討頸動脈粥樣硬化斑塊對腦梗死患者病情及複髮的影響。方法本研究採用前瞻性隊列法設計。應用多普勒超聲進行頸動脈斑塊探查及定性，將患者分為斑塊組和無斑塊組。採用NIHSS評分法評估入選患者入院時、入院後第7 d、第14 d神經功能。對患者進行1年的隨訪，觀察腦梗死複髮情況。結果根據多普勒超聲結果將患者分為斑塊組173例（70．3％）和無斑塊組73例（29．7％）。與無斑塊組比較，斑塊組年齡、NIHSS評分及高血壓、糖尿病、高脂血癥、高纖維蛋白原血癥的比率均顯著高于無斑塊組（P＜0．05～0．01）。在完成隨訪的患者中，斑塊組腦梗死複髮39例（24．84％），複髮時間為10．12箇月；非易損斑塊患者腦梗死複髮時間為11．82箇月，混閤斑塊患者為10．62箇月，易損斑塊患者為9．13箇月。無斑塊組腦梗死複髮7例（10．45％），複髮時間為11．56箇月。斑塊組腦梗死複髮率顯著高于，複髮時間顯著早于無斑塊組（均P＜0．05）。易損斑塊患者複髮時間顯著早于非易損斑塊患者（P＝0．034）。結論頸動脈粥樣硬化斑塊可使急性腦梗死的病情加重，複髮率增高，尤其是易損斑塊患者。
목적：탐토경동맥죽양경화반괴대뇌경사환자병정급복발적영향。방법본연구채용전첨성대렬법설계。응용다보륵초성진행경동맥반괴탐사급정성，장환자분위반괴조화무반괴조。채용NIHSS평분법평고입선환자입원시、입원후제7 d、제14 d신경공능。대환자진행1년적수방，관찰뇌경사복발정황。결과근거다보륵초성결과장환자분위반괴조173례（70．3％）화무반괴조73례（29．7％）。여무반괴조비교，반괴조년령、NIHSS평분급고혈압、당뇨병、고지혈증、고섬유단백원혈증적비솔균현저고우무반괴조（P＜0．05～0．01）。재완성수방적환자중，반괴조뇌경사복발39례（24．84％），복발시간위10．12개월；비역손반괴환자뇌경사복발시간위11．82개월，혼합반괴환자위10．62개월，역손반괴환자위9．13개월。무반괴조뇌경사복발7례（10．45％），복발시간위11．56개월。반괴조뇌경사복발솔현저고우，복발시간현저조우무반괴조（균P＜0．05）。역손반괴환자복발시간현저조우비역손반괴환자（P＝0．034）。결론경동맥죽양경화반괴가사급성뇌경사적병정가중，복발솔증고，우기시역손반괴환자。
Objective To explore the effect of carotid atherosclerotic plaque ( CAP) on severity and recurrence of patients with cerebral infarction ( CI ) .Methods The prospective cohort study was utilized in this research. Existence and type of CAP were detected by Doppler ultrasound, and patients were divided into plaque group and without plaque group.The patients was evaluated by NIHSS on admission and 7 d, 14 d after admission, and patients were followed up for 1 year.The condition of CI recurrence was be observed.Results According to the Doppler ultrasound, patients were divided into plaque group ( 173 cases, 70.3%) and without plaque group ( 73 cases, 29.7%) .Compared with without plaque group, age, NIHSS score and incidences of hypertension, diabetes, hyperlipidemia, hyperfibrinogenemia were significantly increased (P<0.05 -0.01).In the patients who were conducted follow-up, cerebral infarction recurrence was in 39 cases (24.84%) in plaque group, recurrence time was 10.12 month.The recurrence time was 11.82 month in patient with non-vulnerable plaque, it was 10.62 month in patient with mixed plaque, and it was 9.13 month in patient with vulnerable plaque.Cerebral infarct recurrence was in 7 cases (10.45%) in without plaque group, recurrence time was 11.56 month.The recurrence rate in plaque group was significant increased than that in without plaque, however, the recurrence time for without plaque group was longer than that for plaque group ( all P<0.05 ) .The recurrence rate and recurrence time in patient with vulnerable plaque was significantly earlier than that in patient with non-vulnerable plaque (P=0.034).Conclusion The CAP in patients with acute CI can exacerbate the disease, and increase recurrence rate.It is especially in patients with vulnerable plaque.
