踝臂指数评价缺血性脑卒中患者脑动脉狭窄程度的临床研究  

Clinical study of ankle brachial index for evaluating the extent of brain artery stenosis of patients with ischemic stroke

作　　者：谢瑛[1] 

机构地区：[1]首都医科大学教学医院北京电力医院神经康复中心,100073

出　　处：《中华老年心脑血管病杂志》2011年第11期970-973,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：首都医学发展基金资助(2007-3126)

摘　　要：目的评价踝臂指数(ABI)对脑动脉狭窄程度的预测价值,探讨ABI与缺血性脑卒中的关系。方法选择缺血性脑卒中患者200例,采用多普勒超声检测仪对每例患者行ABI测量,同时进行脑血管造影检查。根据北美症状性颈动脉内膜切除试验NASCET分级法将患者分为正常组(40例)、轻度狭窄组(51例)、中度狭窄组(44例)和重度狭窄组(65例),比较每组ABI值,并分析脑动脉狭窄程度与ABI的相关性,计算不同的ABI截断值对缺血性脑卒中患者发生重度脑动脉狭窄的预测作用。结果 200例缺血性脑卒中患者ABI异常率34.5%。与重度狭窄组比较,正常组、轻度狭窄组、中度狭窄组ABI明显升高(P<0.05)。ABI异常是重度颅内动脉狭窄的独立预测因素;ABI≤0.9作为截断值预测缺血性脑卒中脑动脉重度狭窄具有较好的敏感性(83.6%)和特异性(71.5%);颈内动脉、大脑中动脉狭窄程度与ABI呈负相关。结论 ABI≤0.9对脑动脉重度狭窄有较好的预测作用。ABI技术可定量地反映脑动脉粥样硬化程度,有助于临床评价和诊断早期脑动脉粥样硬化性疾病。Objectives To evaluate the value of ankle brachial index（ABI） to predict the extent of stenosis,explore the relationship between ABI and ischemic stroke. Methods 200 acute ischemic stroke patients were selected in this study. ABI was measured in patients by means of Doppler ultrasound device. According to the North American Symptomatic Carotid Endartexectomy Trial grading, all the ischemic stroke patients were divided into normal（40 cases）, slight stenosis（51 cases）, the rnidrange stenosis（44 eases）, and the severe stenosis group（65 cases）, comparing the ABI between different groups,analysing the relationship of ABI with the extent of brain artery steno- sis, calculating the different cutoff values in ABI to predict the presence of severe stenosis in brain artery. Results The ABI abnormal rate in 200 ischemic stroke patients is 34.5 %. The ABI of the severe stenosis group is significantly statistically different from that in the normal,mild and moderate stenosis group（P〈0.05）. Calculating the different cutoff values in ABI to predict the presence of severe stenosis in brain artery,it is clear that the cutoff value in ABI≤0.9 shows a rela-tively better sensitivity（83.6%）and specificity（71.5%）to predict the severe stenosis in brain artery;the extent of stenosis in internal carotid artery and middle cerebral artery correlated negatively with ABI. Conclusions The cutoff value in ABI≤0.9 has a relatively better sensitivity and specificity to predict the severe stenosis in brain artery. ABI can reflect the extent of atheroselerosis and help evaluate and diagnose the early atherosclerosis diseases.

关 键 词：脑动脉疾病 卒中 颅内动脉疾病 超声检查 多普勒 脑血管造影术 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]