联合应用超声技术评价缺血性脑血管病与颈动脉斑块形态特征的相关性  

Joint evaluation of the correlation between ischemic cerebrovascular disease and carotid plaque morphology by ultrasonic technology

作　　者：赵广明[1] 李淑玲[1] 张雷[1] 张丹[1] 付文艳[1] Zhao Guangming Li Shuling Zhang Lei et al(Department of Ultrasound Division,Affiliated Hospital, Inner Mongolia Medical University,Hohhot 010050)

机构地区：[1]内蒙古医科大学附属医院超声诊断科,内蒙呼和浩特010050

出　　处：《中国现代医药杂志》2016年第9期5-8,共4页Modern Medicine Journal of China

基　　金：内蒙古自治区自然科学基金项目(编号:2014MS0899)

摘　　要：目的应用超声技术对颈动脉不同形态斑块的稳定性作出评估,探讨与缺血性脑血管病发生的相关性。方法选取我院经门诊、住院确诊患者52例为实验组,同期45例无缺血性脑血管病患者为对照组,检测其双侧颈动脉(包括颈总动脉、颈内动脉颅外段)斑块形态及狭窄程度,并对斑块行超声造影检查。结果实验组中患高血压、高血脂、高血糖均高于对照组,差异有统计学意义(P<0.05),而且在吸烟及饮酒方面,实验组明显高于对照组;实验组中39例有不同程度颈动脉内膜增厚,粥样硬化斑块形成46例,发生率为75.0%及88.5%,明显高于对照组,而且斑块形态以软斑型及溃疡型为主,合并狭窄程度均高于对照组,两者差异有统计学意义(P<0.05);CUES增强结果显示两组间差异有统计学意义,实验组Ⅱ级以上所占比例较大,而对照组Ⅰ级所占比例较高,表明斑块内新生血管的多少是斑块不稳定的主要特征。两组患者颈动脉斑块超声造影增强定量测值比较,两组的EI值和Ratio比值差异有统计学意义(P<0.05),而且颈动脉超声造影可以增加溃疡型斑块的检出率。结论联合应用超声技术能较准确评估颈动脉不同形态斑块的稳定性,并与缺血性脑血管病有着密切的相关性。Objective To assess the stability of carotid plaques in various forms using ultrasonic technique and investigate its correlation with ischemic cerebrovascular diseases. Methods An experimental group composed of 52 subjects including outpatients and inpatients with confirmed ischemic cerebrovascular diseases,and a control group composed of 45 patients without ischemic cerebrovascular disease were set up in the same period. The degree of narrowness and forms in carotid arteries on both sides（including common carotid artery and outer part of internal carotid artery） were tested. And ultrasonic contrast examination on plaques was also conducted in the present study. Results The rates of hypertension,hyperlipidemia and hyperglycemia in experimental group were significantly higher than those in control group（P〈0.05） and there was a clear difference between these two groups. Besides,the proportion of smoking and drinking in experimental group was higher than that in control group. There were 39 cases with different degree of intimal thickening in carotid artery and 46 cases with atherosclerotic plaques in experimental group,and the incidence ratios were respectively 75.0% and 88.5%,significantly higher than those in control group. Moreover,the plaques in experimental group were mainly composed of soft ones and ulcer plaques and the combined degree of stenosis was significantly higher than that in control group with noticeable differences（P〈0.05）. CUES enhancement results showed significant differences between the two groups： Levels above 2 occupied a larger proportion（77.1%） in experimental group,whereas level was higher（52.1%） in control group. The results indicated that the number of new blood vessels in the plaque was the main feature of unstable plaques. Comparing the contrast-enhanced ultrasonography for the carotid plaques in both groups,it could be concluded that significant differences in EI value and Ratio exist between experimental group and control group（P〈0.05）.Besides,carotid

关 键 词：超声 缺血性脑血管病 颈动脉 斑块 稳定性 造影 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]