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目的 研究脑梗死与颈动脉粥样硬化及血脂、血糖、凝血谱等多因素的关系。方法对１３２例脑梗死患者行颈动脉超声检查，同时检测血脂、血糖、凝血谱等项目。结果 脑梗死组颈动脉粥样斑块发生率７８．７９％，对照组为２３．０８％（Ｐ＜０．００１）。斑块发生部位以颈总动脉分叉处最多为４２．６０％。颈动脉斑块与脑梗死部位存在同侧相关性。颈动脉有斑块的病例其高血压发生率、血总胆固醇及低密度脂蛋白、载脂蛋白Ｂ、纤维蛋白原含量较无斑块的病例显著增高。结论 颈动脉粥样硬化附壁血栓形成脱落或小斑块脱落可以成为大片脑梗死或腔隙性脑梗死的病因。动脉粥样斑块的形成与高血压病史、血总胆固醇和低密度脂蛋白、载脂蛋白Ｂ的指标增高及纤维蛋白原增高有关。
Objective To study the relationship between cerebral infarction and carotid atherosclerosis and blood lipids, blood glucose, coagulation spectrum and other factors. Methods 132 cases of cerebral infarction patients underwent carotid ultrasound, simultaneous detection of blood lipids, blood glucose, coagulation spectrum and other projects. Results The incidence of carotid artery plaque was 78.79% in cerebral infarction group and 23.08% in control group (P <0.001). Plaque occurred at the bifurcation of the common carotid artery up to 42.60%. There was an ipsilateral correlation between carotid plaque and cerebral infarction. Carotid plaque cases, the incidence of hypertension, blood total cholesterol and low density lipoprotein, apolipoprotein B, fibrinogen content was significantly higher than the case without plaque. Conclusion Carotid artery atherosclerosis, mural thrombosis shedding or small plaque off can become the cause of large cerebral infarction or lacunar infarction. Atherosclerotic plaque formation and history of hypertension, blood total cholesterol and low density lipoprotein, apolipoprotein B increased markers and increased fibrinogen.