颈动脉狭窄相关研究进展

Research Progress Related to Carotid Artery Stenosis

摘要: 颈动脉狭窄使患者有缺血性中风的危险，因此临床治疗的目标往往是降低患者并发卒中的风险。大多数颈动脉狭窄患者往往在临床上表现为无症状。颈动脉狭窄引起的中风最常见的机制是斑块破裂和血栓栓塞，与多种基因作用有关。药物治疗是动脉狭窄患者治疗的基石，抗血栓治疗在其中起着至关重要的作用。无症状的颈动脉狭窄患者主要以药物治疗为主，症状性的患者需要通过颈动脉血管重建术干预，不建议为改善认知功能而对无症状的患者使用颈动脉血管重建术干预治疗，颈动脉血管重建术也对大多数患者有着明显受益，包括颈动脉支架置入术、颈动脉内膜剥脱术和经颈动脉血管重建术。颈动脉狭窄的患者的个体最适宜治疗方案的选择，仍是临床的关键问题。

Abstract: Carotid stenosis puts patients at risk of ischemic stroke, so the goal of clinical treatment is often to reduce the risk of stroke. Most patients with carotid stenosis are often asymptomatic in the clinic. The most common mechanism of stroke caused by carotid artery stenosis is plaque rupture and thromboembolism, which is related to many genes. Drug therapy is the cornerstone of the treatment of patients with arterial stenosis, and antithrombotic therapy plays a vital role in it. Asymptomatic patients with carotid artery stenosis are mainly treated with drugs. Symptomatic patients need to be intervened on by carotid artery revascularization. It is not recommended to use carotid artery revascularization for asymptomatic patients to improve cognitive function. Carotid artery revascularization also has obvious benefits for most patients, including carotid stent implantation, carotid endarterectomy and transcarotid artery revascularization. The choice of the most suitable treatment scheme for patients with carotid artery stenosis is still a key clinical problem.