The Research Of Clinical Characteristics About Carotid Artery Plaques

Objective: 1.Through observe and research the pathology and carotid ultrasound results of 43 cases of carotid artery plaque, to analyze the relationship of carotid ultrasound to determine carotid athery plaque stability before carotid endarterectomy operation with the pathological results of carotid athery plaque, to explore the accuracy and feasibility of carotid ultrasound in the preoperative evaluation of carotid artery plaque stability, to understand the guiding role of stripping plaques in carotid endarterectomy operation. Provide basis for early prevention and treatment of cerebral apoplexy, timely surgical intervention and increase operation safety.2. Through observe and research the pathology results of 43 cases of carotid artery plaque, the history of present illness and head MRI examination results, to analyze carotid artery plaque instability in the proportion of different types of cerebral ischemic stroke among 43 cases of carotid artery plaque, different cerebral infarction parts relation with the carotid artery plaque instability, to explore the importance of carotid artery plaque instability in prevention and treatment of cerebral infarction.Provide evidence for systematically prevention, diagnosis, treatment.Objects and Methods: 1. Selection of 43 cases of in the Tianjin Huanhu hospital patients with carotid endarterectomy operation. Through the observation of gross specimen of carotid artery plaque and related histologic examination results plaque stability conclusions, to reach a conclusions of plaque stability. 2. Collection of 43 cases of surgery patient preoperative carotid ultrasound examination results, observe carotid ultrasound results of carotid artery plaque,to reach the plaque stability conclusions, and analysis the correlation of the results and pathology results. 3. Collected 43 cases surgery patients preoperative history of present illness and head MRI examination. According to patients condition and head MRI results to differentiate on the basis of OCSP classification, and to statistics of the measurement data. 4. Analysis of 43 cases of plaque instability in the proportion of different types of cerebral ischemic stroke, and different cerebral infarction parts relation with the carotid artery plaque instability. 5.The data were analyzed with SPSS for Windows Version17.0, the count data using chi square test, the quantitative data using t test.Results: 1. Pathology results: 11 cases of stability plaques(all is Ⅶtype 5 cases), 32 cases of unstable plaques(Ⅳ-Ⅴ17 cases,Ⅵtype 15 cases), withoutⅠ,Ⅱ, Ⅲ,Ⅷtype plaques, 2. Carotid ultrasound results: 32 cases of unstable plaques, 11 cases of stability plaques, there was no statistically significant difference(P > 0.05). Ultrasound and pathology results coincidence rate is higher, there was no statistically significant difference(P > 0.05). 3.OCSP classification: 3 cases of TACI group, 7 cases of PACI group, 2 cases of POCI group, LACI group of 26 patients. 4. Cerebral apoplexy and TIA group of unstable plaque were 85.2% and 72.7%, and higher than asymptomatic group were 20.0%, the difference was statistically significant(P < 0.05). Cerebral apoplexy group of unstable plaque ratio were 85.2%, higher than the TIA group were 72.7%, there was no statistically significant difference(P > 0.05). TACI + PACI unstable plaque was 83.0%, higher than LACI type 80.8%, the difference was statistically significant(P ﹤0.05); POCI unstable plaque was 100.0%, there was no statistically significant difference(P > 0.05).Conclusions: 1. Carotid ultrasound can reflect the pathological type of carotid artery plaque, especially in the identification of the stability of the plaques have higher accuracy, and the surgical CEA and relevant treatment and internal standardization drug treatment has a very important guiding significance.2. Unstable plaque easily lead to the formation of thrombus and embolus fall off, resulting in the occurrence of cerebrovascular events.The acute cerebral infarction parts with middle cerebral artery blood flow of internal carotid artery system is the most frequent, the illness weight, high morbidity.So for this kind of patients with cerebral infarction,should be given early diagnosis, the standard treatment, surgical intervention in time.