超声造影评估颈动脉斑块新生血管与脑白质病变的关系  

作　　者：周喜华 张艳明[2] 宋则周[2] 傅燕飞 耿昱[2] 

机构地区：[1]浙江省宁波市安康医院,315500 [2]浙江省人民医院,310014 [3]杭州市滨江区西兴街道社区卫生服务中心,310051

出　　处：《浙江临床医学》2020年第6期869-870,873,共3页Zhejiang Clinical Medical Journal

摘　　要：目的应用超声造影评估颈动脉斑块新生血管与脑白质病变的关系。方法对39例脑白质病变和45例非脑白质病变患者行超声造影检查并进行颈动脉斑块新生血管分级,比较脑白质病变组和非病变组风险因素和颈动脉斑块新生血管分级差异,分析脑白质病变与风险因素及颈动脉斑块新生血管分级的关系,应用ROC曲线评估颈动脉斑块新生血管分级预测脑白质病变的价值。结果与非病变组比较,脑白质病变组中高龄患者(P=0.005)、高血压(P=0.004)和糖尿病的比例(P=0.002)明显增高;脑白质病变组颈动脉斑块新生血管分级高于非病变组(P=0.000);以颈动脉斑块新生血管分级>Ⅱ级预测脑白质病变的敏感性和特异性分别为71.79%、80.00%,其曲线下面积为0.771(95%CI:0.666~0.855)(P=0.000)。结论颈动脉斑块新生血管的超声造影分级具有预测脑白质病变的价值。Objective To evaluate the relation of white matter lesions to the neovascularization grade of carotid plaque by using contrast enhanced ultrasonography.Methods 39 patients with white matter lesions and 45 patients without white matter lesions were studied by contrast enhanced ultrasonograpy,then the neovascularization grade of carotid plaque was assessed in enrolled patients.The differences of risk factors and the neovascularization grade of carotid plaque were compared between patients with white matter lesions and patients without white matter lesions.The relation of white matter lesions to risk factors and the neovascularization grade of carotid plaque was analysed,and predictive utility of the neovascularization grade of carotid plaque for white matter lesions was evaluated by ROC curve.Results Compared with patients without white matter lesions,the ratio of patients with advanced age(>70 years old)(P=0.005),hypertension(P=0.004)and diabetes mellitus(P=0.002)is higher in patients with white matter lesions.The neovascularization grade of carotid plaque in patients with white matter lesions is higher than that in patients without white matter lesions(P=0.000).The sensitivity and specificity to prediction of white matter lesions by the neovascularization grade of carotid plaque(cutoff value>Ⅱ)was 71.79%and 80.00%respectively and the area under ROC curve is 0.771(95%CI:0.666~0.855)(P=0.000).Conclusion The contrast-enhanced ultrasoud grading of carotid plaque neovascularization is valuable for predicting white matter lesions.

关 键 词：超声检查 造影剂 脑白质病变 颈动脉 动脉硬化 

分 类 号：R54[医药卫生—心血管疾病]