Mizuma Atsushi, Kijima Chikage, Iijima Kazuyuki, Goto Yoshiaki, Honma Kazunari, Yasuda Takashi, Tokuoka Kentaro, Kitagawa Yasuhisa, Takizawa Shunya
Department of Neurology, Tokai University School of Medicine.
Department of Neurology, Tokai University School of Medicine.
Heart Lung Circ. 2014 Oct;23(10):930-5. doi: 10.1016/j.hlc.2014.02.013. Epub 2014 Mar 22.
Aortic plaque is considered a risk factor of ischaemic stroke, and both ulceration and plaque thickness are considered important. However, the relative importance of aortic plaque and carotid plaque remains unclear. The purpose of this study is to clarify the relation between aortic and carotid plaque lesions and atherosclerotic risk factors in patients with acute ischaemic stroke.
We enrolled 76 patients with first-ever ischaemic stroke, undergoing transoesophageal echocardiography, whose aetiology of ischaemic stroke was unknown. We divided the patients into two groups according to aortic plaque thickness, based on previous reports, i.e., a high-risk group (over 4mm) and a low-risk group (less than 4mm). We also examined several atherosclerotic risk factors.
Mean age, gender and hypertension was not significantly different between the low-risk and high-risk group. HDL-cholesterol (P<0.01), LDL/HDL ratio (P<0.05), non-HDL-cholesterol (P<0.05), HbA1c (P<0.05) and eGFR (P<0.01) were significantly different between the two groups. Max plaque thickness in the carotid artery was correlated with aortic plaque lesions.
Multiple atherosclerotic risk factors are associated with greater aortic plaque lesions. Aortic plaque is important not only as an embolic source, but also as one of the atherosclerotic markers.
主动脉斑块被认为是缺血性卒中的一个危险因素，溃疡形成和斑块厚度均被视为重要因素。然而，主动脉斑块和颈动脉斑块的相对重要性仍不明确。本研究的目的是阐明急性缺血性卒中患者主动脉和颈动脉斑块病变与动脉粥样硬化危险因素之间的关系。
我们纳入了76例首次发生缺血性卒中且病因不明的患者，这些患者接受了经食管超声心动图检查。根据既往报道，我们依据主动脉斑块厚度将患者分为两组，即高危组（超过4mm）和低危组（小于4mm）。我们还检测了多种动脉粥样硬化危险因素。
低危组和高危组之间的平均年龄、性别和高血压情况无显著差异。两组之间的高密度脂蛋白胆固醇（P<0.01）、低密度脂蛋白/高密度脂蛋白比值（P<0.05）、非高密度脂蛋白胆固醇（P<0.05）、糖化血红蛋白（P<0.05）和估算肾小球滤过率（P<0.01）存在显著差异。颈动脉最大斑块厚度与主动脉斑块病变相关。
多种动脉粥样硬化危险因素与更严重的主动脉斑块病变相关。主动脉斑块不仅作为栓子来源很重要，而且作为动脉粥样硬化标志物之一也很重要。
