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目的探讨颈部血管动脉硬化斑块与脑卒中的相关性及其与认知功能障碍的关系。方法选择脑卒中患者100例,根据颈动脉硬化斑块支数分为三组进行颈动脉彩色多普勒超声检查,比较各组患者的临床指标,分析硬化斑块发生部位、成分及狭窄度,分析颈动脉硬化斑块与脑卒中的相关性;根据有无认知功能障碍分为两组,分析各组患者的认知功能障碍程度,研究颈动脉粥样硬化与认知功能障碍的关系。结果 100例患者中220处粥样硬化斑块,颈总动脉75例,颈总动脉分叉61例,颈内动脉84例,各种类型斑块在颈动脉中的构成比不同,其中颈动脉及颈内动脉均以Ⅲ型为主,各占46.7%,47.6%;Ⅳ~Ⅴ型、Ⅵ型、Ⅶ型颈动脉的脑卒中发病率分别为68%、70%、60%;脑卒中部位的斑块数目是200处,中度以上斑块的数目是190处,随着颈动脉狭窄的程度逐渐加重,脑卒中发生率也逐渐增大;功能障碍组在注意力、定向力、记忆力、物体命名、书写、语言和结构能力的测评得分明显低于正常组。结论颈动脉斑块的狭窄度、面积均与脑卒中存在正相关,狭窄程度越重,面积越大,出现脑卒中的概率和危险度越高,且颈动脉粥样硬化程度越严重,认知功能损害也会越严重。
Objective To investigate the correlation between vascular atherosclerotic plaque and stroke in the neck and its relationship with cognitive dysfunction. Methods One hundred patients with stroke were selected and divided into three groups according to carotid atherosclerotic plaque count. The carotid artery color Doppler echocardiography was performed. The clinical parameters of each group were compared. The location, composition and stenosis of the plaque were analyzed. The correlation between carotid atherosclerosis and stroke was analyzed. According to the presence or absence of cognitive dysfunction, the patients were divided into two groups. The degree of cognitive dysfunction in each group was analyzed to study the relationship between carotid atherosclerosis and cognitive impairment. Results Among the 100 patients, there were 220 atherosclerotic plaques, 75 common carotid arteries, 61 common carotid bifurcations and 84 internal carotid arteries. The proportions of various types of plaques were different in the carotid arteries, of which carotid artery And internal carotid artery were mainly type Ⅲ, accounting for 46.7% and 47.6% respectively. The incidence of stroke was 68%, 70% and 60% in type Ⅳ, type Ⅴ, type Ⅵ and type Ⅶ carotid arteries respectively. The number of plaques was 200, the number of plaques was 190, with the degree of carotid stenosis gradually increased, the incidence of stroke also increased gradually; dysfunction group in attention, orientation, memory, Object naming, writing, language and structural ability evaluation score was significantly lower than the normal group. Conclusions The stenosis and area of carotid artery plaque are positively correlated with stroke. The more the stenosis is, the larger the area is, the higher the probability and risk of stroke are and the more serious the carotid artery atherosclerosis is. Functional damage will be more serious.