探讨动脉粥样硬化性血栓性脑梗死急性期患者大脑中动脉微栓子的存在与脑梗死复发、预后

的关系。方法连续收集动脉粥样硬化性血栓性脑梗死急性期患者，应用经颅多普勒彩色超声微栓子监测，彩色多

普勒超声颈动脉检测，颅内、颈动脉磁共振血管成像，以及神经功能缺损评价，并登记卒中复发和卒中

后死亡情况。结果　入组的49例患者中，支大动脉粥样硬化性狭窄或斑块形成，33例患者症状性狭窄；有症状性狭

窄比无症状性狭窄患者微栓子发生率升高（p=0.），不稳定斑块的患者微栓子阳性率升高（p=0.

）。微栓子阴性较微栓子阳性的患者一周内容易出现神经功能缺损NIHSS评分的改善（p=0.），mRS评

分的变化情况未出现显著差异（p=0.），复发、死亡也未显示统计学差异（p=0.）。结论　动脉粥样硬化性血栓性脑梗死患者颈动脉不稳定斑块，微栓子阳性率升高；微栓子阴性较微栓子

阳性的患者一周内更容易出现神经功能缺损改善。关键词:动脉粥样硬化性血栓性脑梗死；微栓子；经颅多普勒彩色超声；卒中复发MicroembolicSignalsMonitoringofPatientswithAtheroscleroticCerebralInfarctionDejinSun,AixiaZhuang,QinghongZeng,YulongJiang,JiandongJiang,ShouqinFeng,YiZhang,HongmeiHuang,HongxiaNie,LiLiu(DepartmentofNeurology,theSecondHospitaloftheCityofLianyungang,Lianyungang,

,China)AbstactObjective　Todeterminetherelationshipofcarotidatherosclerosisandmicroembolicsignal

(MES)inpatientswithatheroscleroticcerebralinfarction.Methods:73patientswithacute

cerebralinfarction(CI)wererecruited.TheMESofcerebralarterieswasmonitoredby

transcranialdoppler(TCD),extra-andintra-cranialmagneticresonanceangiographywas

performedandcarotidatherosclerosislesionsweredetectedbycolorDopplersonography.

ThenseverityofneurologicaldeficitswasevaluatedusingNIHSSscores.Thecasesofstroke

recurrenceandpost-strokedeathwererecorded.Results:In49patientsrecruited,therewerelargevesselswithatherosclerotic

plaquesorstenosis.33patientswithacuteCIwereduetosymptomaticcerebral

atheroscleroticstenosis.IncidenceofpositiveMESswashigherinpatientswith

symptomaticstenosisthaninthosewithasymptomaticones(p=0.).Occurrenceofpositive

MESswaselevatedinpatientswithunstableplaques(p=0.).Comparedwithpatientswith

positiveMESs,thetendencyofNIHSSscorereductionwasobservedin7daysamongpatients

withnegativeMES(p=0.).However,therewasnosignificantlydifferencebetweenthemin

changeofmodifiedRankinScale(p=0.)orincidenceofrecurrenceanddeath(p=0.).Conclusion:TheincidenceofpositiveMESswaselevatedinatheroscleroticcerebral

infarctionpatientswithunstableplaques.And

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