Gray-Weale分型对症状性颈动脉斑块的诊断价值  

Diagnostic value of Gray-Weale classification in symptomatic carotid plaque

作　　者：高雪[1] 王永槐[2] 王瑶[1] 梁杰[1] 魏凤英[1] 娄喆 GAO Xue;WANG Yonghuai;WANG Yao;LIANG Jie;WEI Fengying;LOU Zhe(Ultrasonic Department,Tieling Central Hospital of Liaoning Province,Tieling,Liaoning,112000;Department of Cardiovascular Ultrasound,the First Hospital Affiliated to China Medical University,Shenyang,Liaoning,110001)

机构地区：[1]辽宁省铁岭市中心医院超声科,辽宁铁岭112000 [2]中国医科大学附属第一医院心血管超声科,辽宁沈阳110001

出　　处：《实用临床医药杂志》2022年第13期41-44,共4页Journal of Clinical Medicine in Practice

基　　金：辽宁省高等学校基本科研项目(LQNK201701)。

摘　　要：目的探讨症状性颈动脉斑块Gray-Weale(GW)分型的分布特点及临床应用价值。方法随机选取行颈动脉多普勒超声检查且在颈动脉分叉部存在动脉粥样硬化(AS)斑块的住院患者60例为研究对象。根据患者6个月内是否出现过缺血性脑血管事件,将其分为症状组(n=32)与无症状组(n=28)。分析患者斑块GW分型;超声评估患者颈动脉分叉部斑块厚度、斑块长度、斑块数量。结果通过斑块GW分型共分析60枚颈动脉分叉部斑块,症状组斑块32枚,其中Ⅰ型6枚,Ⅱ型17枚,Ⅲ型7枚,Ⅴ型2枚;无症状组斑块28枚,其中Ⅰ型2枚,Ⅱ型7枚,Ⅲ型17枚,Ⅳ型2枚。2组斑块GW分型比较,差异有统计学意义(P<0.05)。症状组斑块厚度大于无症状组,差异有统计学意义(P<0.05)。斑块GW分型与斑块厚度呈负相关(r=-0.53,P<0.01)。Cohen's Kappa一致性检验结果显示Cohen's Kappa系数为0.874(95%CI:0.7662~0.9818,P<0.001)。结论斑块GW分型对颈动脉粥样硬化斑块回声特性的评估稳定性与重复性较好,斑块GW分型可以作为筛查症状性颈动脉斑块的有效手段。Objective To investigate the distribution characteristics and clinical application value of Gray-Weale(GW)classification of symptomatic carotid plaque.Methods Sixty inpatients with carotid artery bifurcation atherosclerosis(AS)plaques undergoing carotid doppler ultrasonography were randomly selected.Patients were divided into symptomatic group(n=32)and asymptomatic group(n=28)according to whether they had experienced an ischemic cerebrovascular event within 6 months.The GW classification of patients'plaques was analyzed.Carotid artery bifurcation plaque thickness,plaque length and the number of plaque were evaluated by ultrasound.Results A total of 60 carotid bifurcation plaques were analyzed by GW classification,32 plaques in symptom group,including 6 with type Ⅰ,17 with type Ⅱ,7 with type Ⅲ,and 2 with type Ⅴ;there were 28 plaques in asymptomatic group,including 2 plaques in type Ⅰ,7 plaques in type Ⅱ,17 plaques in type Ⅲ,2 plaques in type Ⅳ.There was statistically significant difference between the two groups in GW classification(P<0.05).The plaque thickness in the symptomatic group was significantly higher than that in the asymptomatic group(P<0.05).There was a negative correlation between plaque GW classification and plaque thickness(r=-0.53,P<0.01).Cohen's Kappa consistency test results showed that Cohen's Kappa coefficient was 0.874(95%CI,0.7662 to 0.9818,P<0.001).Conclusion GW plaque classification has good stability and repeatability in evaluating echo characteristics of carotid atherosclerotic plaques.Plaque GW classification can be used as an effective method to screen symptomatic carotid plaque.

关 键 词：超声检查 颈动脉斑块 Gray-Weale分型 缺血性脑血管事件 

分 类 号：R543.1[医药卫生—心血管疾病] R445.1[医药卫生—内科学]