青年脑梗死患者颈动脉彩色多普勒超声分析

【】　目的　评价青年人颈动脉彩色多普勒超声检查的临床意义，并探讨青年人脑梗死与颈动脉粥样硬化的关系。　方法　2008年2月-2011年3月，对256例青年脑梗死患者进行颈动脉彩色多普勒超声检测，选择性别和年龄匹配的健康青年143例作对照组，比较两组人群颈动脉彩色多普勒超声特点的差异。　结果　脑梗死组颈动脉粥样硬化斑以中等、强回声斑块为主，斑块积分、血管壁内-中膜厚度（ITM值）及斑块检出率（34.77%，89例）均明显高于对照组（P<0.01）；脑梗死组颈动脉硬化狭窄率及血栓发生率明显高于对照组（P<0.05，<0.01）。　结论　青年脑梗死患者颈动脉粥样硬化及血栓形成发生率均高，提示青年脑梗死患者的发病主要原因与动脉粥样硬化有关。IMT值的增加、斑块的检出率及形态学特征等是颈动脉病变与脑梗死发生的有意义的检测指标，在青年人脑梗死的防治中是有参考意义较大的超声学指标。【Abstract】　Objective　ToassesstheclinicalsignificanceofcolorDopplerultrasonographyinexaminingcarotidarteriesofyoungpatients,andexploretherelationshipbetweencerebralinfarctionandcarotidarteriosclerosisinyoungpatients.　Methods　Atotalof256patientswithcerebralinfarctionand143peoplewithoutcerebralinfarctiondiagnosedbetweenFebruary2008andMarch2011wereassessedbycolordopplerultrasonography.Theultrasoniccharacteristicsofthetwogroupswerecomparedandanalyzed.　Results　Plaquesincidenceincerebralinfarctiongroupwas81.43%whichwashigherthanthatinthecontrolgroup.Themostcommonsitesofplaqueformationwerecommoncarotidartery(CCA)bifurcateandtheinitialsegmentofinternalcarotidartery(ICA)inyoungpeoplewithcerebralinfarction.Inthecerebralinfarctiongroup,therateofmiddle-echoicplaqueswashigherthanthatinthecontrolgroup(P<0.05).Therateoflow-gradecarotidstenosiswashigherinthecerebralinfarctiongroupthanthatinthecontrolgroup(P<0.05).　Conclusions　Cerebralinfarctionoccurrenceinyoungpeopleiscloselycorrelatedtocarotidarteryatherosclerosis.Ultrasonographycanprovideobjectiveevidencesforpreventingandtreatingcerebralinfarction.