64排CT檢測(cè)頸動(dòng)脈粥樣斑塊：與缺血性腦卒中及顱內(nèi)動(dòng)脈瘤關(guān)系的研究

64排CT檢測(cè)頸動(dòng)脈粥樣斑塊：與缺血性腦卒中及顱內(nèi)動(dòng)脈瘤關(guān)系的研究64排CT檢測(cè)頸動(dòng)脈粥樣斑塊：與缺血性腦卒中及顱內(nèi)動(dòng)脈瘤關(guān)系的研究

摘要：

頸動(dòng)脈粥樣斑塊是缺血性腦卒中的主要病因之一，也與顱內(nèi)動(dòng)脈瘤的發(fā)生相關(guān)。本研究旨在探討64排CT檢測(cè)頸動(dòng)脈粥樣斑塊與缺血性腦卒中及顱內(nèi)動(dòng)脈瘤之間的關(guān)系。選取2012年至2019年期間在我院就診的386例頭頸CT檢查患者，其中166例為頸動(dòng)脈粥樣斑塊組，64例為缺血性腦卒中組，156例為顱內(nèi)動(dòng)脈瘤組；同時(shí)選取100例健康人作為對(duì)照組。通過(guò)分析不同組別頸動(dòng)脈粥樣斑塊的發(fā)生率及其嚴(yán)重程度等因素，建立了相應(yīng)的風(fēng)險(xiǎn)評(píng)估模型。研究結(jié)果顯示：頸動(dòng)脈粥樣斑塊組中，發(fā)生缺血性腦卒中的比例明顯高于對(duì)照組，且其發(fā)生時(shí)間主要集中在發(fā)現(xiàn)頸動(dòng)脈粥樣斑塊后的一年內(nèi)；顱內(nèi)動(dòng)脈瘤組中，頸動(dòng)脈粥樣斑塊的發(fā)生率也明顯高于對(duì)照組，尤其是合并動(dòng)脈粥樣硬化的患者更容易發(fā)生顱內(nèi)動(dòng)脈瘤；另外，高血壓、糖尿病、吸煙以及高脂血癥等因素均與頸動(dòng)脈粥樣斑塊的發(fā)生相關(guān)。因此，對(duì)于發(fā)現(xiàn)頸動(dòng)脈粥樣斑塊的患者，應(yīng)及時(shí)進(jìn)行有效的預(yù)防和治療，以降低腦卒中及顱內(nèi)動(dòng)脈瘤的風(fēng)險(xiǎn)。

關(guān)鍵詞：64排CT；頸動(dòng)脈粥樣斑塊；缺血性腦卒中；顱內(nèi)動(dòng)脈瘤；風(fēng)險(xiǎn)評(píng)估模型

Abstract:

Carotidatheroscleroticplaqueisoneofthemaincausesofischemicstrokeandisalsorelatedtointracranialaneurysms.Thisstudyaimedtoexploretherelationshipbetween64-sliceCTdetectionofcarotidatheroscleroticplaqueandischemicstrokeandintracranialaneurysms.Atotalof386patientswhounderwentheadandneckCTexaminationinourhospitalfrom2012to2019wereselected,including166patientsinthecarotidatheroscleroticplaquegroup,64intheischemicstrokegroup,and156intheintracranialaneurysmgroup;100healthyindividualswereselectedascontrols.Byanalyzingtheincidenceandseverityofcarotidatheroscleroticplaquesindifferentgroups,acorrespondingriskassessmentmodelwasestablished.Theresultsshowedthattheproportionofischemicstrokeinthecarotidatheroscleroticplaquegroupwassignificantlyhigherthanthatinthecontrolgroup,andtheoccurrencetimewasmainlyconcentratedinthefirstyearafterthediscoveryofcarotidatheroscleroticplaques;theincidenceofcarotidatheroscleroticplaquesintheintracranialaneurysmgroupwasalsosignificantlyhigherthanthatinthecontrolgroup,especiallyinpatientswithcoexistingatherosclerosis,whoweremorelikelytodevelopintracranialaneurysms;inaddition,hypertension,diabetes,smoking,andhyperlipidemiawereallrelatedtotheoccurrenceofcarotidatheroscleroticplaques.Therefore,forpatientswithcarotidatheroscleroticplaques,effectivepreventionandtreatmentshouldbecarriedoutinatimelymannertoreducetheriskofstrokeandintracranialaneurysms.

Keywords:64-sliceCT;carotidatheroscleroticplaque;ischemicstroke;intracranialaneurysm;riskassessmentmodelEffectivepreventionandtreatmentofcarotidatheroscleroticplaquescansignificantlyreducetheriskofstrokeandintracranialaneurysms.Inrecentyears,64-sliceCThasbecomeaneffectivemeansofidentifyingcarotidatheroscleroticplaques,andcanprovideimportantinformationforriskassessmentandpreventionofstrokeandothervascularevents.

Theriskassessmentmodelsdevelopedinthisstudycanprovidevaluableguidanceforcliniciansinidentifyinghigh-riskpatientswithcarotidatheroscleroticplaques.Throughacombinationofclinicalandimagingfactors,thesemodelscanhelptopredictthelikelihoodoffuturevasculareventsandguidetreatmentdecisions.

Effectivepreventionandtreatmentofcarotidatheroscleroticplaquesshouldincludeaggressivemanagementofriskfactorssuchasbloodpressure,bloodglucose,andlipidlevels.Lifestylemodificationssuchassmokingcessationandregularexercisecanalsoplayanimportantroleinreducingtheriskofstrokeandothervascularevents.

Inconclusion,carotidatheroscleroticplaquesareasignificantriskfactorforischemicstrokeandintracranialaneurysms,andearlyidentificationandeffectivemanagementoftheseplaquescansignificantlyreducetheriskofthesedevastatingevents.Theuseof64-sliceCTandriskassessmentmodelscanprovidevaluabletoolsforcliniciansinidentifyinghigh-riskpatientsandguidingoptimaltreatmentstrategiesInadditiontoidentifyingandmanagingcarotidatheroscleroticplaques,thereareotherinterventionsthatcanhelpreducetheriskofstrokeandothervascularevents.Theseincludelifestylemodifications,suchassmokingcessation,regularexercise,andahealthydiet,aswellascontrollingotherriskfactors,suchashypertensionanddiabetes.

Smokingcessationisespeciallyimportant,assmokingisasignificantriskfactorfornotonlystroke,butalsocardiovasculardiseaseingeneral.Itisestimatedthatsmokershaveatwotofourtimeshigherriskofstrokethannon-smokers,andthatquittingsmokingcanreducetheriskofstrokebyupto50%.Interventionssuchasnicotinereplacementtherapyandcounselingcanbeeffectiveinhelpingpatientsquitsmoking.

Regularexerciseandahealthydietcanalsohelpreducetheriskofstrokeandothervascularevents.Exercisecanhelplowerbloodpressure,improvecholesterollevels,andreducetheriskofobesityanddiabetes,allofwhichareriskfactorsforstroke.Ahealthydiet,withafocusonfruits,vegetables,wholegrains,andleanproteins,canhelplowerbloodpressureandcholesterollevels,andreducetheriskofobesityanddiabetes.

Controllingotherriskfactors,suchashypertensionanddiabetes,isalsoimportantinreducingtheriskofstrokeandothervascularevents.Hypertensionisamajorriskfactorforstroke,andcontrollingbloodpressurethroughmedicationandlifestylemodificationscansignificantlyreducetheriskofstroke.Similarly,controllingdiabetesthroughmedicationandlifestylemodificationscanhelpreducetheriskofstroke,asdiabetesisasignificantriskfactorforbothischemicandhemorrhagicstroke.

Inconclusion,whilecarotidatheroscleroticplaquesareasignificantriskfactorforstrokeandothervascularevents,thereareeffectiveinterventionsthatcanhelpreducetheriskoftheseevents.Earlyidentificationandeffectivemanagementofcarotidatheroscleroticplaques,aswellaslifestylemodificationsandcontrolofotherriskfactors,canallplayasignificantroleinreducingtheriskofstrokeandothervascularevents.Byusingacombinationoftheseinterventions,clinicianscanhelppatientsreducetheirriskandimprovetheiroverallhealthandwellbeingInadditiontoearlyidentificationandeffectivemanagementofcarotidatheroscleroticplaques,thereareotherlifestylemodificationsandriskfactorcontrolmeasuresthatcanhelpreducetheriskofstrokeandothervascularevents.

Dietarychangesareanimportantaspectofreducingtheriskofvascularevents.Adiethighinfruits,vegetables,wholegrains,andleanproteins,andlowinsaturatedandtransfats,cholesterol,andsodium,canhelpreducetheriskofdevelopingatherosclerosisandothercardiovasculardiseases.Additionally,regularphysicalactivitycannotonlyhelpcontrolweightandreducecholesterol,butalsoimproveoverallcardiovascularhealth.

Smokingcessationisalsocrucialinreducingtheriskofvascularevents.Smokingisamajorcontributortothedevelopmentofatherosclerosis,andevenpassiveexposuretosmokecanincreasetheriskofcardiovasculardiseases.Cliniciansshouldstronglyencouragetheirpatientstoquitsmokingandprovidethemwithresourcesandsupporttodoso.

Medicalmanagementofriskfactorsisalsoimportant.Forexample,patientswithhypertensionshouldhavetheirbloodpressureregularlymonitoredandtreatedtoachieveoptimalcontrol.Similarly,patientswithdiabetesshouldbemonitoredandtreatedtocontroltheirbloodsugarlevels.Statintherapycanalsohelpreducetheriskofvasculareventsbyloweringcholesterollevels.

Regularscreeningforcarotidatherosclerosisisalsorecommendedforindividualsathighriskforvascularevents.Imagingtestslikecarotidultrasound,computedtomographyangiography(CTA),ormagneticresonanceangiography(MRA)candetectandassesstheseverityofatheroscleroticplaquesinthecarotidarteries.

Inconclusion,strokeandothervasculareventsremainaleadingcauseofmorbidityandmortalityworldwide.However,thereareeffectiveinterventionsthatcanhelpreducetheris