颈动脉

Surface tear of the endomembrane and atherosclerotic plaque induced by balloon dilatation, mechanical expansion and carotid sinus draw-off can adjust compliance of the carotid wall, change sensitiveness of carotid artery receptor, cause instability of hemadynamics and defluxion of plaque fragments, lead to hypotension, bradycardia, hypertension and vascular embolism. How to control and reduce occurrence of above-mentioned complications is a main problem in present studies.

但由于球囊扩张、支架置入机械扩张和牵拉，颈动脉窦引起内膜和动脉粥样硬化斑块的表面撕裂，调整了颈动脉壁顺应性，改变了颈动脉受体的敏感性，引起血液动力学不稳定和斑块碎片脱落，引起低血压、心动过缓、高血压及血管栓塞等并发症，如何控制和减少上述并发症的发生是目前研究的主要问题。

PART ONEInvestigation on Hp CagA+ strain infection condition and pathogenesis risk analyze in patients of carotid atherosclerosisObjective To observate pathological changes of carotid atherosclerosis as well as Hp infection situation, examinate blood fats, blood serum hs-CRP, blood plasma YKL-40, blood serum sCD14, analyze relations between Hp or Hp CagA+ strain and carotid atherosclerosis, and explore possible mechanism of carotid atherosclerosis caused by infection.

然后进行基础动物实验，应用Hp CagA+菌株干预高脂血症大兔，建立Hp CagA+菌株感染致兔颈动脉粥样硬化模型，进行血清Hp抗体、hs-CRP、血浆YKL-40水平检测、斑块内Hp DNA，进一步求证Hp CagA+菌株感染和颈动脉粥样硬化形成的相关性，Hp CagA+菌株感染是否可促进颈动脉粥样硬化的形成，深入探讨其可能机制，以期为颈动脉粥样硬化形成的病因学研究提供实验基础，为临床治疗颈动脉粥样硬化提供新的策略，从而完善其防治模式。

Abstract］ objective to identify the relationship between serum homocysteine and carotid artery atherosclerosis in patients with cerebral infarction and effects of foliate,methylcobalamin.methods the concentrations of hcy were determined by means of fluorescence polarization immunoassay and carotid arteries was examined with color doppler ultrasound in 165 patients with cerebral infarction.the subjects were divided into 4 groups according to the severity of lesion of carotid artery.the concentrations of hcy were compared in different groups.the patients with hyperhomocysteinemia received foliate and methylcobalamin.results when lesion of carotid artery became severer,serum hcy was higher.the intima medial thicknesses of carotid artery were significantly decreased in patients with hyperhomocysteinemia who received foliate and methylcobalamin for two years.conclusion hyperhomocysteinemia may play an important role in development of carotid artery atherosclerosis.the intervention of foliate and methylcobalamin may reduce carotid artery atherosclerosis.

摘要］ 目的探讨脑梗死患者颈动脉病变与血清同型半胱氨酸水平的关系及叶酸、甲钴胺长期干预对其影响。方法对165例急性脑梗死患者进行血清hcy的测定及颈动脉超声检查，并按动脉硬化的程度分组，比较不同程度颈动脉粥样硬化患者hcy水平，部分高hcy血症患者给予叶酸、甲钴胺干预，随访2年。结果随着颈动脉病变程度的加重，血清hcy浓度呈上升趋势，高hcy血症干预者动脉内中膜厚度明显减小。结论高hcy血症对颈动脉粥样硬化的形成起重要作用，长期给予叶酸、甲钴胺干预可能减轻颈动脉粥样硬化。

RESULTS: The imaging features of CBT were masses located at the bifurcation of the carotid artery, with abundant blood supply in the tumor, the internal and external carotid arteries shifted, the bifurcation of the carotid artery increased like goldcup in DSA. The imaging features of the neurilemmoma were masses located behind the bifurcation of the carotid artery, and the carotid bifurcation was normal, no blood supply in the tumor, but carotid arteries shifted.

结果：颈动脉体瘤的CDFI和DSA特征为：颈总动脉分权处单发性肿块，并与其紧密相连，瘤体内血流极为丰富，瘤体使颈外动脉向前内移位、颈内动脉向后外移位，颈内、外动脉分权角度增大明显，DSA呈高脚杯状改变；神经鞘瘤紧邻颈动脉，颈总动脉分权处角度无改变，瘤体内血流信号不丰富，瘤体使颈动脉向前、外移位。

Result: Among 40 cases of hyperpiesia, there are 32 cases with arteria carotis atherogenesis in different extent, and its incidence is 80%; Among 32 cases of cerebral vessels diseases: Twenty-one cases had arteria carotis atherogenesis, and its incidencewas 66%. Among 18 cases of diabetes complicated with hyperpiesia, 13 cases had arteria carotis atherogenesis, and its incidence was 72%; Among 6 cases of diabetes, 2 cases had arteria carotis atherogenesis, and its incidence was 33%.

结果 40例高血压患者中，32例颈动脉有不同程度的粥样斑块形成，发病率80％；32例脑血管病变患者，21例颈动脉有不同程度的粥样斑块形成，发病率66％；糖尿病合并高血压18例糖尿病患者中，13例颈动脉有不同程度的粥样斑块形成，发病率72％；6例糖尿病患者中，2例颈动脉有不同程度的粥样斑块形成，发病率33％。

Result: Among 40 cases of hyperpiesia, there are 32 cases with arteria carotis atherogenesis in different extent, and its incidence is 80%; Among 32 cases of cerebral vessels diseases: Twenty-one cases had arteria carotis atherogenesis, and its incidencewas 66%.

结果 40例高血压患者中，32例颈动脉有不同程度的粥样斑块形成，发病率80％；32例脑血管病变患者，21例颈动脉有不同程度的粥样斑块形成，发病率66％；糖尿病合并高血压18例糖尿病患者中，13例颈动脉有不同程度的粥样斑块形成，发病率72％；6例糖尿病患者中，2例颈动脉有不同程度的粥样斑块形成，发病率33％。

Results (1)CIMT and FIMT in CHD group were significantly higer than those in non-CHD group(p＜0.05), The detection rate of plaques in CHD group was significantly higer than those in non-CHD group(p＜0.05);(2) The sensitivity of carotid and femoral atherosclerosis plaques in young CHD patients was 62% and 57%. The specificity was 90% and 86%. The positive predictive value of carotid and femoral atherosclerosis plaques in young CHD patients was 92% and 88%. The negative predictive value was 58% and 53%. The predictive value of combinant measurement of carotid and femoral atherosclerosis plaques was not improved.

结果 （1）冠心病组CIMT、FIMT与非冠心病组比较，前者均高于后者（p＜0.05）；冠心病组颈动脉、股动脉粥样硬化斑块检出率均明显高于非冠心病组（p＜0.05）；（2）颈动脉、股动脉粥样硬化斑块预测年轻冠心病的敏感性分别为62%、57%，特异性为90%、86%，阳性预测值分别为92%、88%，阴性预测值为58%、53%；颈动脉、股动脉联合检测未见明显提高预测值。

Results Masses were located at the branch of common carotid artery,so the interval between external and internal carotid arteries was enlarged.Low echoic substantial masses with clearly boundary were found.The bigger masses always grew around carotid arteries.More color flow signals were detected in the masses and most were arterial flow.

结果 颈动脉体瘤肿块位于颈总动脉分叉处，颈内及颈外动脉间距增宽，瘤体常呈实质性低回声，边界清晰，较大瘤体常围绕血管生长；彩色多普勒超声显示肿瘤内丰富彩色血流信号，以动脉血流为主，能显示瘤体与颈动脉的关系。

1.Preliminary studys on the carotid artery parameters Detected by Intracavitary Convex Array ProbePurpose and SignificanceFinal results of The North American Symptomatic Carotid Endarterectomy Trial and the MRC European Carotid Surgery Trial displayed that carotid artery must be observed intimately when stegnosis degree is higher than 50%and it must have an operation or interventional therapy in time when stegnosis degree is higher than 70%.

1、腔内凸阵超声探头检测颈动脉参数的初步研究目的和意义北美有症状颈动脉内膜剥脱试验(The North American Symptomatic CarotidEndarterectomy Trial NASCET)和欧洲颈动脉手术试验(European Carotid SurgeryTrial，ECST)研究结果显示，当颈动脉狭窄程度超过50%时要密切观察病情变化，当狭窄程度超过70%时要及时手术或介入治疗，治疗后可大幅降低脑梗死的发生率。

We analyzed 77 cases of unilateral or bilateral carotid disease which were diagnosed by TCD and cerebral angiography reported by Lindegaard 1985.The ratio of compensative blood mean velocitywith carotid disease and the identical lateral middle cerebral arterial blood mean velocity－Vm/Vmca can be used as a medium for the analysis of 81(out of 154)laterals carotid pathological changes,which was reported by Lindegaard.

应用15例我科经TCD诊断并由MR、颈动脉双功B超或DSA证实的一侧颈内动脉狭窄或闭塞的病例，与Lindegaard〔2〕报道的77例经TCD和脑血管造影诊断的一侧或双侧颈动脉病变的病例进行分析，将颈动脉病变时代偿血流的平均流速Vm与同侧大脑中动脉平均流速Vmca的比值作为本组15例与Lindegaard的77例81侧颈动脉病变分析的桥梁。

Breath, muscle contraction of the buttocks; arch body, as far as possible to hold his head, right leg straight towards the ceiling (peg-leg knee in order to avoid muscle tension).

呼气，收缩臀部肌肉；拱起身体，尽量抬起头来，右腿伸直朝向天花板（膝微屈，以避免肌肉紧张）。

The cost of moving grain food products was unchanged from May, but year over year are up 8%.

粮食产品的运输费用与5月份相比没有变化，但却比去年同期高8％。