腔隙性脑梗死颈动脉超声检查及风险因素和预后研究  

Value of carotid ultrasonography risk factors and prognosis in patients with lacunar infarction

作　　者：张涛[1] 翟栋材[1] 张晓愉[1] ZHANG Tao;ZHAI Dong-cai;ZHANG Xiao-yu(Department of Ultrasound,Xingtai People’s Hospital,Xingtai 054001,Hebei,China)

机构地区：[1]邢台市人民医院超声科,河北邢台054001

出　　处：《生物医学工程与临床》2021年第1期30-34,共5页Biomedical Engineering and Clinical Medicine

基　　金：河北省重点研发计划自筹项目(172777205)。

摘　　要：目的分析腔隙性脑梗死患者的颈动脉超声表现和风险因素及预后,对临床上颈动脉超声检查在早期诊断腔隙性脑梗死中的意义进行探讨。方法选择邢台市人民医院接受超声检查的80例患者,其中男性47例,女性33例;年龄36~84岁,平均年龄65.0岁;体质量指数20.2~27.3 kg/m^(2),平均体质量指数23.7kg/m^(2);高血压51例,糖尿病17例,血脂异常40例。按腔隙性脑梗死和非腔隙性脑梗死分为2组,每组40例。行超声检查和脑MRI扫描。比较两组患者基本临床资料、颈动脉斑块数量、腔隙性脑梗死风险因素及患者预后。结果腔隙性脑梗死颈动脉无斑块患者数显著低于非腔隙性脑梗死(χ^(2)=13.11,P<0.05);腔隙性脑梗死颈动脉稳定斑块患者数和不稳定斑块患者数均显著高于非腔隙性脑梗死(P<0.05);腔隙性脑梗死患者脑梗死同侧颈动脉不稳定斑块数与对侧比较,差异有统计学意义(t=3.06,P<0.05);腔隙性脑梗死患者脑梗死同侧颈动脉稳定斑块数与对侧相比,差异无统计学意义(t=2.17,P>0.05)。腔隙性脑梗死患者脑梗死同侧颈动脉稳定斑块数和不稳定斑块数与非腔隙性脑梗死患者脑梗死双侧颈动脉稳定斑块数和不稳定斑块数相比,差异均具有统计学意义(P<0.05)。Logistic回归分析显示,年龄、男性、高血压、血脂异常和糖尿病都是腔隙性脑梗死的风险因素(P<0.05)。预后分析显示,腔隙性脑梗死患者全因死亡率较低(χ^(2)=4.06,P<0.05),Barthel指数评分较高(t=3.17,P<0.05),但脑出血复发比例与非腔隙性脑梗死组差异无统计学意义(χ^(2)=3.12,P>0.05)。结论腔隙性脑梗死的风险因素有颈动脉粥样硬化、年龄、男性、高血压、血脂异常和糖尿病。虽然腔隙性脑梗死患者短期预后良好,但远期预后较差。因此,明确腔隙性脑梗死的常见风险因素,并通过超声检查评估患者颈动脉粥样硬化的情况对腔隙性脑梗死的早治疗具有重要的�Objective To analyze the carotid ultrasoundgraphy,risk factors and prognosis in patients with lacunar infarction,and explore the significance of clinical carotid ultrasonography in the early diagnosis of lacunar infarction.Methods A total of 80 patients were enrolled,which included 47 males and 33 females,aged 36-84 years old with mean age of 65.0 years old;body mass index(BMI)was 20.2-27.3 kg/m^(2) with mean BMI of 23.7 kg/m^(2);51 cases of hypertension,17 cases of diabetes and 40 cases of dyslipidemia.According to lacunar infarction and non-lacunar infarction,all patients were divided into 2 groups,with 40 cases in each group.The basic clinical data,carotid plaques numbers,risk factors of lacunar infarction and prognosis of patients between 2 groups were compared.Results The number of patients without carotid plaque in lacunar infarction group was significantly lower than that in non-lacunar infarction group(χ^(2)=13.11,P<0.05);The number of patients with carotid stable plaque and unstable plaques in lacunar infarction were significantly higher in lacunar infarction group than those in nonlacunar infarction group(P<0.05).The number of instability plaques in ipsilateral carotid artery was significantly different than in contralateral side of patients with lacunar infarction(t=3.06,P<0.05).There was no difference in numbers of stability plaques between ipsilateral and contralateral carotid artery of patients with lacunar infarction(t=2.17,P>0.05).The number of stable plaques and unstable plaques of ipsilateral carotid artery in 2 groups were significantly different(P<0.05).The Logistic regression analysis showed that age,male,hypertension,dyslipidemia and diabetes were risk factors for lacunar infarction(P<0.05).The prognostic analysis showed that patients with lacunar infarction had lower all-cause mortality(χ^(2)=4.06,P<0.05),higher Barthel index(BI)scores(t=3.17,P<0.05),and similar recurrence rate of cerebral hemorrhage than patients with non-launar infarction(χ^(2)=3.12,P>0.05).Conclusion It is demonstrate

关 键 词：腔隙性脑梗死 年龄 高血压 血脂异常 糖尿病 预后因素 

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]