乐秀芬　陈振宇

[摘要] 目的 探讨超声检查颈动脉粥样斑块与缺血性脑卒中的关系及其危险因素分析。 方法 回顾性分析疑似颈动脉粥样硬化的患者162例的彩色多普勒超声资料，分析颈动脉粥样硬化与缺血性脑卒中的关系，并分析其危险因素。 结果 162例患者中，颈动脉粥样硬化118例，其中缺血性脑卒29例，占24.6%，无颈动脉粥样患者44例，其中缺血性脑卒中3例，占6.8%，两组间比较差异有统计学意义（P<0.05）。颈动脉粥样硬化组颈动脉内径、内膜中层厚度大于无颈动脉粥样硬化组，最大剪切率、最小剪切率均小于无颈动脉粥样硬化组，差异有统计学意义（P<0.01）。左心耳血栓、颈动脉IMT，頸动脉内径，颈动脉最大SR，颈动脉最小血流速度及颈动脉阻力指数是影响颈动脉粥样斑块的超声危险因素（P<0.05）。 结论 左心耳血栓、颈动脉IMT、颈动脉内径、颈动脉最大SR、颈动脉最小血流速度及颈动脉阻力指数是影响颈动脉粥样硬化的超声危险因素，而颈动脉粥样硬化是缺血性脑卒中的危险因素。

[关键词] 彩色多普勒超声；颈动脉粥样硬化；缺血性脑卒中；危险因素

[中图分类号] R445.1 [文献标识码] B [文章编号] 1673-9701（2017）23-0092-03

[Abstract] Objective To investigate the relationship between carotid atherosclerotic plaque and ischemic stroke by ultrasonography and analyze its risk factors. Methods Color Doppler ultrasound data of 162 patients with suspected carotid atherosclerosis were retrospectively analyzed. The relationship between carotid atherosclerosis and ischemic stroke was analyzed， and the risk factors were analyzed. Results Among the 162 patients， there were 118 cases of carotid atherosclerosis， among whom 29 cases were ischemic stroke， accounting for 24.6%. There were 44 patients without carotid atherosclerosis， including 3 cases of ischemic stroke， accounting for 6.8%. There was statistically significant difference between the two groups（P<0.05）. Carotid diameter， intima-media thickness in the carotid atherosclerosis group were higher than those in non-carotid atherosclerosis group. The maximum shear rate and the minimum shear rate were both lower than those in the non-carotid atherosclerosis， and the differences were statistically significant（P<0.01）. The left atrial appendage thrombus， carotid artery IMT， carotid diameter， carotid maximum SR， carotid minimum blood flow velocity and carotid resistance index were the risk factors for carotid atherosclerotic plaque（P<0.05）. Conclusion Left athal appendage thrombus， the carotid IMT， carotid diameter， carotid maximum SR， carotid minimum blood flow velocity and carotid resistance index are the ultrasound risk factors for carotid atherosclerosis， and carotid atherosclerosis is the risk factor for ischemic stroke.

[Key words] Color Doppler ultrasound； Carotid atherosclerosis； Ischemic stroke； Risk factors

颈动脉粥样硬化是缺血性脑卒中的危险因素之一，通过筛查颈动脉粥样硬化斑块形成情况，对高危人群进行早发现及早治疗，对预防急性脑梗死发生有重要作用[1，2]。研究认为血流剪切力的异常是导致动脉粥样硬化的发病机制之一，血流剪切力的异常导致斑块脱落、形成栓子堵塞动脉管腔，与缺血性脑卒中存在着密切联系[3，4]。本研究分析疑似颈动脉粥样硬化患者的临床资料，行超声检查，分析影响颈动脉粥样硬化的危险因素及颈动脉粥样硬化与缺血性脑卒中的关系。现报道如下。

1 资料与方法

1.1一般资料

选择2012年1月～2013年12月在我院诊断治疗的疑似颈动脉粥样硬化患者162例的临床资料进行回顾性分析。超声检测结果显示118例患者有颈动脉粥样硬化发生为颈动脉粥样硬化组，44例患者无颈动脉粥样硬化发生为无颈动脉粥样硬化组。两组的性别、年龄比较，差异无统计学意义（P>0.05）。……