超声定量参数与后循环TIA患者血管内皮功能关系及预测后循环脑梗死的效能  

The relationship between quantitative ultrasound parameters and vascular endothelial function in patients with posterior circulation TIA and its efficacy in predicting posterior circulation cerebral infarction

作　　者：杨丽花 丁凌[2] 徐敏 YANG Lihua;DING Ling;XU Min(Department of Ultrasound Imaging,General Hospital of the Yantze River Shipping,Wuhan 430000,China;Department of Ultrasound Imaging,Affiliated Renhe Hospital of China Three Gorges University,Yichang 443000,China)

机构地区：[1]长江航运总医院超声影像科,湖北武汉430000 [2]三峡大学附属仁和医院超声影像科,湖北宜昌443000

出　　处：《医学影像学杂志》2022年第10期1662-1665,1669,共5页Journal of Medical Imaging

摘　　要：目的 探讨超声评估颈总动脉顺应性、椎动脉内径、收缩期血流峰值(PSV)与后循环短暂性脑缺血发作(TIA)患者血管内皮功能的相关性及预测后循环脑梗死(PCCI)的效能。方法 选取我院收治的157例后循环TIA患者进行前瞻性分析,根据3个月内是否发生PCCI分为PCCI组(n=56)、无PCCI组(n=101)。比较两组一般资料、颈总动脉顺应性、椎动脉左侧和右侧内径、PSV、肱动脉充血反应性扩张(DTRH)及含服硝酸甘油后血管内径的变化(DTNG),分析颈总动脉顺应性、椎动脉内径、PSV与DTRH、DTNG的相关性,探讨PCCI发生相关影响因素,评价颈总动脉顺应性、椎动脉PSV预测PCCI的效能。结果 颈总动脉顺应性与DTRH呈正相关,椎动脉左侧和右侧PSV均与DTRH呈负相关(P <0.05)。颈总动脉顺应性、椎动脉左侧和右侧PSV是PCCI发生的影响因素(P <0.05)。颈总动脉顺应性、椎动脉左侧和右侧PSV联合预测PCCI的AUC最大,为0.847。结论 颈总动脉顺应性、椎动脉PSV与后循环TIA患者血管内皮功能存在良好线性关系,对临床预测PCCI发生风险具有较高应用价值。Objective To investigate the correlation of the compliance of the common carotid artery,the inner diameter of the vertebral artery,the peak systolic velocity(PSV)and the vascular endothelial function of patients with posterior circulation transient ischemic attack(TIA)evaluated by ultrasound and the effectiveness of ultrasound evaluation in predicting posterior circulation cerebral infarction(PCCI).Methods 157 patients with posterior circulation TIA admitted to our hospital were selected for prospective study,and they were divided into PCCI group(n=56)and no PCCI group(n=101)according to whether PCCI occurred within 3 months.The general data,the compliance of the common carotid artery,the left and right inner diameters of the vertebral artery,PSV,the dilation to reactive hyperemia(DTRH),and the change of dilation to nitroglycerin administration(DTNG)of the two groups were compared.The correlation of compliance of the common carotid artery,the inner diameter of the vertebral artery,and PSV and DTRH and DTNG were analyzed.The related factors affecting the occurrence of PCCI were discussed.The effectiveness of the compliance of the common carotid artery and PSV of the vertebral artery in predicting PCCI were evaluated.Results The compliance of the common carotid artery was positively correlated with DTRH,and the PSV on the left and right sides of the vertebral artery was negatively correlated with DTRH(P<0.05).The compliance of the common carotid artery and PSV on the left and right sides of the vertebral artery were the influencing factors of PCCI(P<0.05).The compliance of the common carotid artery and the PSV on the left and right sides of the vertebral artery jointly predicted the maximum AUC of PCCI,which was 0.847.Conclusion There is a good linear relationship between the compliance of the common carotid artery,the PSV of the vertebral artery and the vascular endothelial function of patients with posterior circulation TIA,which has high application value for clinical prediction of the risk of PCCI.

关 键 词：颈总动脉顺应性 椎动脉内径 收缩期血流峰值 后循环短暂性脑缺血发作 后循环脑梗死 超声诊断 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]