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颈动脉粥样硬化斑块与急性缺血性脑卒中的相关性研究
引用本文:昝芹,陈晓荣,杨文琼.颈动脉粥样硬化斑块与急性缺血性脑卒中的相关性研究[J].CT理论与应用研究,2023,32(1):105-112.
作者姓名:昝芹  陈晓荣  杨文琼
作者单位:1.锦州医科大学国药东风总医院研究生培养基地, 湖北 十堰442008
基金项目:湖北省自然科学基金面上项目(血管活性肽Salusins与缺血性脑卒中相关性研究(2012FFB02003))
摘    要:目的:运用颈动脉CTA分析颈动脉粥样硬化斑块,探讨斑块性质及部分因素与急性缺血性脑卒中的相关性,从而为急性缺血性脑卒中的预防和治疗提供参考和依据。方法:回顾性分析行颈动脉CTA检查、且在颈动脉CTA检查前或后一周内行磁共振DWI检查的患者,根据磁共振DWI判断有无前循环急性缺血性脑卒中,将患者分为急性缺血性脑卒中组(95例)和非急性缺血性脑卒中组(102例);对两组患者的临床资料、实验室资料和CTA显示的颈动脉斑块性质、斑块表面形态进行分析,比较两组之间有无统计学差异,对P <0.05的指标纳入急性缺血性脑卒中发生的多因素Logistic回归分析。结果:两组间在年龄、高血压病史、TC、TG、HDL、HCY、CysC、HbA1c指标中差异有统计学意义;两组间在斑块性质及斑块表面形态间差异有统计学意义,在颈动脉管腔狭窄程度间差异无统计学意义;多因素回归分析提示年龄≥65岁、高血压、TC、HDL、HCY及脂质斑块是急性缺血性脑卒中发生的危险因素。结论:颈动脉粥样硬化与急性缺血性脑卒中发生相关,脂质斑块是急性缺血性脑卒中发生的危险因素;颈动脉CTA可以对斑块性质进行判断,结合部分实验室指...

关 键 词:颈动脉CTA  颈动脉斑块  急性缺血性脑卒中
收稿时间:2022-03-03

Correlation between Carotid Atherosclerotic Plaques and Acute Ischemic Stroke
Institution:1.Postgraduate Training Base of Jinzhou Medical University, Sinopharm Dongfeng General Hospital, Shiyan 442008, China1.Hubei University of Medicine, Shiyan 442008, China Department of Medical Imaging2.Hubei University of Medicine, Shiyan 442008, China Department of Neurology, Affiliated Dongfeng Hospital
Abstract:Objective: Carotid artery computed tomography angiography (CTA) was used to analyze carotid atherosclerotic plaques and explore the correlation of plaque properties and other factors with the occurrence of acute ischemic stroke. The aim was to provide a basis for the prevention and treatment of acute ischemic stroke. Methods: Patients who underwent carotid artery CTA and magnetic resonance diffusion-weighted imaging (DWI) within 2 weeks before or after carotid artery CTA were analyzed retrospectively. Based on magnetic resonance DWI data, these patients were divided into the acute ischemic stroke group (n=95) and non-acute ischemic stroke group (n=102). The clinical data, laboratory data, and nature and surface morphology of the carotid plaques on CTA were compared between the two groups. Variables with P<0.05 were included in a multivariate logistic regression analysis to determine the risk factors of acute ischemic stroke. Results: Age, hypertension history, and levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), homocysteine (Hcy), cystatin C (Cys-C), and glycated hemoglobin (HbA1c) differed significantly between the two groups. Multivariate regression analysis revealed that age ≥65 years (odds ratio OR]: 4.95), hypertension (OR: 9.91), high TC (OR: 2.78), high Hcy (OR: 3.07), high HbA1c (OR: 4.60), and lipid plaque (OR: 4.89) were the independent risk factors for acute ischemic stroke. A high HDL level (OR of 0.13) was identified as a protective factor for the development of acute ischemic stroke. Conclusion: Carotid atherosclerosis is related to acute ischemic stroke occurrence. Furthermore, the presence of lipid plaques is a risk factor for acute ischemic stroke. Combined with some laboratory indicators, carotid artery CTA can judge the nature of carotid plaques and provide a basis for the prevention and treatment of acute ischemic stroke. 
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