中青年颈内动脉血栓的超声影像特征分析及预后
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摘要
目的分析总结中青年颈内动脉血栓患者的超声影像学特征及预后,为预防该类疾病、提高脑卒中诊治水平提供临床依据。方法连续收集我院血管超声发现并经CT血管造影术(CTA)确诊的40例中青年颈内动脉血栓患者,分析总结其临床特征及超声影像学特征。结果中青年ICH男性好发,非体力劳动者居多。伴发疾病中以高同型半胱氨酸血症最多见(20%)、大动脉炎次之(12.5%)。临床症状最多见的是单侧肢体麻木无力,53.3%患者有脑梗死。超声表现特点是动脉硬化程度轻,单侧好发,完全充填型血栓好发于右侧ICA,颈内动脉血栓内部回声多以暗淡回声为主(97.5%),少数患者受累侧颈内动脉内径变细(12.5%),而颈总动脉受累者(大动脉炎、动脉粥样硬化)占多数(60%)。随访该类患者预后不良,仅53.8%达到基本治愈、生活自理。结论中青年ICH患者具有一定发病特征及超声特征,且易伴发代谢性疾病,需引起临床重视,积极对原发病进行系统治疗,改善预后提高生存质量。
Objective To analyze and summarize the ultrasonographic features and prognosis of young and middle-aged patients with internal carotid artery thrombosis(ICH),in order to provide clinical evidence for preventing ICH and improving the diagnosis and treatment of cerebral apoplexy in young and middle-aged people.Methods 40 ICH patients(age≤45 years)diagnosed by vascular ultrasound imaging and confirmed with CT Angiography(CTA)from 2007-2017 were enrolled.The typical clinical characteristics and ultrasonic imaging features were summarized.Results Male and non-manual workers were common in young and middle-aged ICH patients,and there is a high proportion accompanying hyperhomocysteinemia(20%)and arteritis(12.5%).The most common clinical symptoms are unilateral limb numbness and weakness,and cerebral infarct occurred in 53.3% patients.Ultrasonographic features included mild arteriosclerosis degree,unilateral predilection,and complete occlusion of thrombus were more commonly seen on the right side.The internal echo of ICH was mostly dim echo(97.5%).The internal diameter of the involved internal carotid artery was thinner in some patients(12.5%),while the common carotid artery involvement accounted for the majority(60%).Follow-up showed that prognosis was poor in young and middle-aged ICH patients,only53.8% of these patients were basically cured and maintained self-care daily life.Conclusions Some typical clinical and ultrasonographic characteristics were shown in young and middle-aged ICH patients,and they are easily accompanied with metabolic diseases,which should be paid more attention in the clinical work,and the primary diseases should be treated systematically in time to improve the prognosis and the quality of life of these patients.
Objective To analyze and summarize the ultrasonographic features and prognosis of young and middle-aged patients with internal carotid artery thrombosis(ICH),in order to provide clinical evidence for preventing ICH and improving the diagnosis and treatment of cerebral apoplexy in young and middle-aged people.Methods 40 ICH patients(age≤45 years)diagnosed by vascular ultrasound imaging and confirmed with CT Angiography(CTA)from 2007-2017 were enrolled.The typical clinical characteristics and ultrasonic imaging features were summarized.Results Male and non-manual workers were common in young and middle-aged ICH patients,and there is a high proportion accompanying hyperhomocysteinemia(20%)and arteritis(12.5%).The most common clinical symptoms are unilateral limb numbness and weakness,and cerebral infarct occurred in 53.3% patients.Ultrasonographic features included mild arteriosclerosis degree,unilateral predilection,and complete occlusion of thrombus were more commonly seen on the right side.The internal echo of ICH was mostly dim echo(97.5%).The internal diameter of the involved internal carotid artery was thinner in some patients(12.5%),while the common carotid artery involvement accounted for the majority(60%).Follow-up showed that prognosis was poor in young and middle-aged ICH patients,only53.8% of these patients were basically cured and maintained self-care daily life.Conclusions Some typical clinical and ultrasonographic characteristics were shown in young and middle-aged ICH patients,and they are easily accompanied with metabolic diseases,which should be paid more attention in the clinical work,and the primary diseases should be treated systematically in time to improve the prognosis and the quality of life of these patients.
引文
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[5]赵园园,吴玉泉,蔡韵,等.血栓前体蛋白与老年脑梗死患者颈动脉粥样硬化的相关性研究[J].中华老年心脑血管病杂志,2015,17(6):619-621.
[6]李勇,高同型半胱氨酸血症对脑梗死发病率的影响[J].中国实用医药,2012,7(34):57.
[7]张俊英,韩卉芳,关艳.高同型半胱氨酸血症与冠心病相关性探讨[J].中国药物与临床,2014,14(8):1129-1130.
[2]王星,吕玲环,王磌,等.彩色多普勒超声对脑梗死患者颈动脉粥样硬化斑块的诊断价值[J].中国超声医学杂志,2000,16(9):685-687.
[3]中国医师协会超声医师分会编著.血管和浅表器官超声检查指南[M].北京:人民军医出版社,2011:25.
[4]谷云,刘学成,杨文.老年脑梗死与颈动脉粥样硬化的关系[J].中国实验诊断学,2008(5):640-643.
[5]赵园园,吴玉泉,蔡韵,等.血栓前体蛋白与老年脑梗死患者颈动脉粥样硬化的相关性研究[J].中华老年心脑血管病杂志,2015,17(6):619-621.
[6]李勇,高同型半胱氨酸血症对脑梗死发病率的影响[J].中国实用医药,2012,7(34):57.
[7]张俊英,韩卉芳,关艳.高同型半胱氨酸血症与冠心病相关性探讨[J].中国药物与临床,2014,14(8):1129-1130.