初诊急性脑梗死患者颈动脉斑块强化程度与短期脑梗死再发的关系探究  

RELATIONSHIP BETWEEN CAROTID PLAQUE ENHANCEMENT DEGREE AND OCCURRENCE OF SHORT-TERM CEREBROVASCULAR EVENTS IN PATIENTS WITH NEWLY DIAGNOSED ACUTE CERE-BRAL INFARCTION

作　　者：张琳琳 陈洁[1] 冯伟 张重阳[1] 陈青松 王耀辉[1] 杨欢 张鑫宇[1] 吕喆[1] ZHANG Linlin;CHEN Jie;FENG Wei;ZHANG Chongyang;CHEN Qingsong;WANG Yaohui;YANG Huan;ZHANG Xinyu;LV Zhe(Department of Emergency,Qinhuangdao First Hospital,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市第一医院急诊科,066000

出　　处：《中国煤炭工业医学杂志》2023年第3期239-243,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省自然科学基金资助项目(编号:F2019203511);秦皇岛市科学技术研究与发展计划项目(编号:202004A021)。

摘　　要：目的探讨初诊急性脑梗死患者颈动脉斑块强化程度与短期脑梗死再发的关系。方法选取2019年12月—2021年12月该院收治的110例初诊急性脑梗死患者作为观察对象,入院时所有患者均行双侧颈动脉三维超声检查,随访6个月并记录脑梗死再发情况,将其分为再发组(n=45例)与未发组(n=65例),比较二组入院时颈动脉斑块三维超声参数差异,分析颈动脉斑块三维超声参数与短期内脑梗再发的相关性及对再发的预测价值。结果再发组45例患者共检测出52个斑块,未发组65例共检测出81个斑块。再发组灰阶中位数低于未发组(P<0.05),血管壁面积、标准化管壁指数高于对照组(P<0.05);二组斑块厚度、斑块体积、血管腔面积比较差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,合并高脂血症、冠心病、病变动脉中重度狭窄、低水平的灰阶中位数及高水平的血管壁面积、标准化管壁指数均是影响短期内脑梗再发的独立危险因素。ROC结果显示,灰阶中位数、血管壁面积、标准化管壁指数对短期内脑梗再发患者预后诊断的AUC分别为0.826、0.738、0.807,具有较高的诊断价值。结论初诊急性脑梗死患者短期内再发脑梗与低水平的灰阶中位数及高水平的血管壁面积、标准化管壁指数有关,临床可考虑观察动脉斑块三维超声参数水平判断预后。Objective To explore the relationship between degree of carotid plaque enhancement and occurrence of short-term cerebrovascular events in patients with newly diagnosed acute cerebral infarction.Methods One hundred and ten patients with newly diagnosed acute cerebral infarction who were treated in the hospital from December 2019 to December 2021 were selected as observation subjects.All patients underwent bilateral carotid artery three-dimensional ultrasound examination at admission and were followed up for 6 months,and the recurrence of cerebral infarction was recorded within 6 months.According to the short-term recurrence of cerebral infarction,the patients were divided into recurrence group(n=45)and non-recurrence group(n=65).Differences in carotid plaque three-dimensional ultrasound parameters were compared between the two groups at admission,and the correlation between three-dimensional ultrasound parameters of carotid plaque and short-term recurrence of cerebral infarction and their predictive value on recurrence were analyzed.Results 52 plaques were detected among 45 patients in recurrence group,and 81 plaques were detected among 65 patients in non-recurrence group.The gray-scale median of recurrence group was lower than that of non-recurrence group(P<0.05),and the vessel wall area and normalized wall index were larger or higher than those of control group(P<0.05).There were no statistical differences in plaque thickness,plaque volume and vascular lumen area between the two groups(P>0.05).Multivariate Logistic regression analysis showed that low level of gray-scale median and high levels of vessel wall area and normalized wall index were independent risk factors for short-term recurrence of cerebral infarction.ROC results revealed that the AUCs of gray-scale median,vessel wall area,and normalized wall index in the diagnosis of prognosis of patients with short-term recurrent cerebral infarction were 0.826,0.738 and 0.807 respectively,with high diagnostic value.Conclusion Short-term recurrence of cerebral inf

关 键 词：急性脑梗死 动脉粥样硬化斑块 三维超声 脑梗死再发 

分 类 号：R743.3[医药卫生—神经病学与精神病学]