急性缺血性脑血管病患者颈内动脉壁面切应力与复发的相关性  

Correlation between internal carotid artery wall shear stress and relapse in acute ischemic cerebrovascular disease

作　　者：张莹[1] 傅贤 曾宪凡 徐洁 刘红英[1] 李现亮[1] 高庆春[1] ZHANG Ying;FU Xian;ZENG Xianfan;XU Jie;LIU Hongying;LI Xianliang;GAO Qingchun(Depart-ment of Neurology,the Second Affiliated Hospital,Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院神经内科,广州510260 [2]深圳市宝安区松岗人民医院,广东深圳518105

出　　处：《实用医学杂志》2023年第6期738-741,共4页The Journal of Practical Medicine

基　　金：广州市卫生健康科技一般引导项目(编号:20201A011088)。

摘　　要：目的 研究伴有颈内动脉粥样斑块的急性缺血性脑血管病患者颈内动脉壁面切应力(wall shear stress,WSS)与复发的相关性。方法 收集广州医科大学附属第二医院神经内科2018年1月至2020年12月住院的98例首发急性缺血性脑血管病患者,筛选出彩超提示颈内动脉斑块形成者,计算壁面切应力,并随访2年记录复发情况。结果 左侧WSS(WSS-L)、右侧WSS(WSS-R)、平均WSS(WSS-M)复发组均高于对照组[(10.16±5.02)vs.(7.82±2.50);(10.22±2.09)vs.(7.82±2.82);(10.19±3.16)vs.(7.82±2.24)]dyne/cm^(2),复发组白细胞计数高于对照组(8.67±1.67 vs. 6.35±1.93)×109/L,差异有统计学意义(P值分别为0.039,0.015,0.008,0.001)。复发与WSS-R(r=0.372,P=0.007)、WSS-M(r=0.305,P=0.029)及白细胞计数(r=0.466,P=0.001)正相关。ROC曲线分析法分析WSS-M对复发的预测价值:当WSS-M为7.95时,最大敏感度和特异度为80%和56%。结论 伴颈内动脉粥样斑块的急性缺血性脑血管病患者颈内动脉WSS与疾病复发相关。Objective To investigate the relationship between internal carotid artery wall shear stress(WSS)and relapse in patients with acute ischemic cerebrovascular disease complicated by internal carotid athero⁃sclerotic plaque.Methods Ninety⁃eight patients with atherosclerotic plaques in internal carotid artery who had been hospitalized in the Second Affiliated Hospital of Guangzhou Medical University from January 2018 to December 2020 were analyzed.The wall shear stress was calculated and the relapse was recorded during a follow⁃up of two years.Results Left WSS(WSS⁃L),right WSS(WSS⁃R)and mean WSS(WSS⁃M)in the relapse group were higher than those in the control group(10.16±5.02 vs.7.82±2.50,10.22±2.09 vs.7.82±2.82,and 10.19±3.16 vs.7.82±2.24)dyne/cm^(2),and the WBC count in the relapse group was higher than that in the control group(8.67±1.67 vs.6.35±1.93)×109/L,the difference was statistically significant(P=0.039,0.015,0.008,and 0.001).Relapse was positively correlated with WSS⁃R(r=0.372,P=0.007),WSS⁃M(r=0.305,P=0.029),and WBC count(r=0.466,P=0.001).The predictive value of WSS⁃M for relapse was analyzed by the ROC curve analysis.As WSS⁃M was 7.95,the maximum sensitivity and specificity were 80%and 56%.Conclusions Internal carotid artery WSS is related to the relapse in the patients with acute ischemic cerebrovascular disease com⁃plicated by atherosclerotic plaques.

关 键 词：缺血性脑血管病 颈内动脉 壁面切应力 复发 

分 类 号：R743.3[医药卫生—神经病学与精神病学]