目的:探讨脑梗死患者颈动脉、股动脉粥样硬化及其相关因素的关系.方法:对409例脑梗死患者(脑梗死组)与104例非脑梗死患者(对照组)行颈动脉、股动脉血管超声检查和血液生化检查,比较2组间动脉粥样硬化斑块及其相关危险因素.结果:脑梗死组颈总、颈内、股总动脉斑块检出率分别为75.1%、66.5%、38.1%,均明显高于对照组的25.0%、20.2%和16.3%(P<0.01);脑梗死组颈动脉内中膜厚度(IMT)(1.5±0.42) mm及斑块积分(2.74±0.15)、股动脉IMT(1.34±0.37) mm及斑块积分(2.26±0.29)均明显高于对照组颈动脉IMT(0.9±0.53) mm及斑块积分(1.13±0.27)、股动脉IMT(0.79±0.31) mm及斑块积分(1.03±0.16)(P<0.01);脑梗死组总胆固醇、甘油三酯、低、高密度脂蛋白胆固醇、纤维蛋白原和尿酸水平均高于对照组(P<0.05～P<0.01).结论:高脂血症、高尿酸血症、颈动脉斑块及股动脉斑块是脑梗死的危险因素;通过检查血脂、血尿酸、颈动脉斑块、股动脉斑块可早期预防脑梗死,降低脑梗死的患病率及致残率.%Objective: To evaluate the relationship of carotid, femoral atherosclerosis and its related factors with cerebral infarction .Methods: Four hundred and nine patients with cerebral infarction were detected by Cobr Doppler and the levels of cholesterol, triglyceride, low density lipoprotein, high density lipoprotein, fibrinogen, uric acid were evaluated, and compared with those of 104 patients who had no cerebral infarction in control group. Results: The plaque detection rates of cerebral carotid, internal carotid and fenoral artery were 75.1% ,66.5% ,38.1% , respectively, which were significantly higher than tiose in control group,25. 0% ,20. 2% and 16.3%(P <0. 01). Carotid artery intima-media thickness( MT) (1. 5 ±0.42) mm and plaque score(2. 74 ±0. 15), femoral artery MT(1.34 ±0. 37) mm and plaque score(2. 26 ±0. 29) in cerebral infarction group were significantly higher than those in control group which the MT of carotid artery was(0.9 ±0.53) mm and plaque score was(1. 13 ±0.27), MT of femoral artery (0.79 ±0.31) mm and plaque score(1.03 ±0.16) (P <0.01). Total cholesterol triglycerides, low densily lipoprotein, fibrinogen and uric acid levels in cerebral infarction group were significantly higher than tiose in control group(P <0.05 - P <0. 01). Conclusions:Hyperlip idemia, hyperuricania, carotid and femoral artery plaque are risk factors for cerebral infarction; it is possible to prevent famoral arteiy infarction early and reduce the incidence of cerebral infarction and disability by checking the levels of blood lipids, blood uric acid, carotid arteiy and fenoral arteiy plaque.
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