64排CT检测颈动脉粥样斑块：与缺血性脑卒中及颅内动脉瘤关系的研究

64排CT检测颈动脉粥样斑块：与缺血性脑卒中及颅内动脉瘤关系的研究64排CT检测颈动脉粥样斑块：与缺血性脑卒中及颅内动脉瘤关系的研究

摘要：

颈动脉粥样斑块是缺血性脑卒中的主要病因之一，也与颅内动脉瘤的发生相关。本研究旨在探讨64排CT检测颈动脉粥样斑块与缺血性脑卒中及颅内动脉瘤之间的关系。选取2012年至2019年期间在我院就诊的386例头颈CT检查患者，其中166例为颈动脉粥样斑块组，64例为缺血性脑卒中组，156例为颅内动脉瘤组；同时选取100例健康人作为对照组。通过分析不同组别颈动脉粥样斑块的发生率及其严重程度等因素，建立了相应的风险评估模型。研究结果显示：颈动脉粥样斑块组中，发生缺血性脑卒中的比例明显高于对照组，且其发生时间主要集中在发现颈动脉粥样斑块后的一年内；颅内动脉瘤组中，颈动脉粥样斑块的发生率也明显高于对照组，尤其是合并动脉粥样硬化的患者更容易发生颅内动脉瘤；另外，高血压、糖尿病、吸烟以及高脂血症等因素均与颈动脉粥样斑块的发生相关。因此，对于发现颈动脉粥样斑块的患者，应及时进行有效的预防和治疗，以降低脑卒中及颅内动脉瘤的风险。

关键词：64排CT；颈动脉粥样斑块；缺血性脑卒中；颅内动脉瘤；风险评估模型

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