颈动脉超声在症状性颈动脉狭窄风险评价中的应用  

Application of carotid ultrasound in risk assessment of symptomatic carotid stenosis

作　　者：凌天金[1] 刘娟[2] 周华东[2] 杜文华[3] 蒋晓江[2] 许志强[2] 

机构地区：[1]四川省资阳市第一人民医院神经内科,641300 [2]第三军医大学大坪医院野战外科研究所神经内科 [3]第三军医大学大坪医院野战外科研究所超声诊断科

出　　处：《临床超声医学杂志》2013年第7期467-470,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的分析颈动脉狭窄患者粥样斑块的影像学特征,并评价症状性颈动脉狭窄的危险因素。方法脑血管造影明确为中度以上狭窄的患者215例（症状性颈动脉狭窄组112例,非症状性颈动脉狭窄组103例）,行颈动脉超声检查,并进行颈动脉粥样斑块回声分级和形态学评价,分析症状性颈动脉狭窄的相关因素。结果症状组软斑、溃疡型斑块及重度狭窄比例明显多于无症状组（P﹤0.05）,症状组颈动脉狭窄率明显高于无症状组（P﹤0.05）,单因素分析提示颈动脉狭窄率、重度狭窄、软斑及溃疡型斑块均与颈动脉狭窄脑梗死发生相关,多因素分析提示重度颈动脉狭窄（OR2.644,95%CI1.432~4.882）和溃疡型斑块（OR2.725,95%CI1.017~7.299）与颈动脉狭窄脑梗死发生独立相关。结论重度颈动脉狭窄和溃疡型斑块是中度以上颈动脉狭窄患者发生缺血性脑梗死的重要危险因素,可以作为颈动脉狭窄患者分层治疗的评价指标。Objective To analyze retrospectively the imaging characteristics of carotid atherosclerotic plaque in patients with carotid stenosis and to evaluate associated risk factors of symptomatic carotid stenosis. Methods A total of 215 patients with more than moderate carotid stenosis confirmed by digital subtraction angiography underwent carotid ultrasound, including symptomatic carotid stenosis group（n=112）and asymptomatic carotid stenosis group（n=103）. Echo classification and morphology of carotid atherosclerotic plaques were assessed. The associated risk factors of symptomatic carotid stenosis were analyzed. Results Patients with soft,ulcerative plaque and severe carotid stenosis were more in symptomatic group than those in asymptomatic group（P﹤0.05）.Degree of carotid stenosis was higher in symptomatic group than that in asymptomatic group （P﹤0.05）. Univariate analysis showed that degree of carotid stenosis,severe carotid stenosis,soft plaque and ulcerative plaque were associated with symptomatic carotid stenosis significantly. Multivariate logistic analysis showed that severe carotid stenosis （OR 2.644,95%CI 1.432~4.882）and ulcerative plaque（OR 2.725,95%CI 1.017~7.299）were associated independently with symptomatic carotid stenosis. Conclusion Severe carotid stenosis and ulcerative plaque are important risk factors of ischemic stroke and can be used as reference indictors for stratification treatment of carotid stenosis.

关 键 词：超声检查 颈动脉粥样斑块 缺血性脑梗死 

分 类 号：R445.1[医药卫生—影像医学与核医学]