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目的探讨慢性肾脏病(CKD)患者颈动脉粥样硬化与缺血性脑卒中之间的关系。方法采用彩色多普勒超声诊断仪,检测88例CKD患者颈动脉粥样硬化程度,统计分析缺血性脑卒中的发生情况。结果 88例CKD患者中,24例(27.3%)并发缺血性脑血管病。CKD患者并发脑卒中者(A组)TG、GFR、CRP检测结果与未并发脑卒中者(B组)比较差异有统计学意义(P<0.05)。88例CKD患者中,颈动脉IMT≥1.0 mm者28例(31.8%),颈动脉斑块形成者13例(14.8%)。颈动脉IMT≥1.0 mm患者并发脑卒中率与IMT正常者比较差异有统计学意义(P<0.05);有颈动脉斑块患者并发缺血性脑卒中率与无颈动脉斑块患者比较差异有统计学意义(P<0.05)。结论 CKD患者发生缺血性脑卒中与炎症反应、脂代谢紊乱及肾小球滤过率下降、颈动脉粥样硬化程度相关。CKD患者颈动脉粥样硬化发生率较高,应采用超声技术检查颈动脉IMT值及斑块形成情况,为早期干预预防脑卒中提供参考依据。
Objective To investigate the relationship between carotid atherosclerosis and ischemic stroke in patients with chronic kidney disease (CKD). Methods The color Doppler ultrasound diagnostic apparatus was used to detect the degree of carotid atherosclerosis in 88 CKD patients and the incidence of ischemic stroke was statistically analyzed. Results Of the 88 CKD patients, 24 (27.3%) had ischemic cerebrovascular disease. The difference of TG, GFR and CRP between CKD patients with stroke (group A) and those without stroke (group B) was statistically significant (P <0.05). Of the 88 patients with CKD, 28 (31.8%) had carotid IMT ≥ 1.0 mm and 13 (14.8%) had carotid plaque formation. The carotid artery IMT ≥ 1.0 mm patients with concurrent stroke rate and normal IMT were significantly different (P <0.05); carotid plaque patients with ischemic stroke rate compared with patients without carotid artery plaque were Statistical significance (P <0.05). Conclusions CKD patients have ischemic stroke and inflammatory reaction, disorder of lipid metabolism, glomerular filtration rate and the degree of carotid atherosclerosis. CKD patients with high incidence of carotid atherosclerosis, ultrasound should be used to check the carotid IMT value and plaque formation, provide a reference for the early intervention in the prevention of stroke.