基于CT血管造影评价颈动脉狭窄急性脑梗死患者颈动脉低密度斑块与复发性脑血管事件的关系  

Evaluation of the Relationship between Carotid Artery Low-density Plaque and Recurrent Cerebrovascular Events in Patients with Acute Cerebral Infarction of Carotid Artery Stenosis Based on CT Angiography

作　　者：朱芬[1] 朱芳 ZHU Fen;ZHU Fang(Nanchang Hongdu Hospital of TCM,Nanchang 330008,China;不详)

机构地区：[1]南昌市洪都中医院,江西南昌330008 [2]江西省精神病医院

出　　处：《中国医学创新》2023年第26期156-160,共5页Medical Innovation of China

摘　　要：目的:探究基于CT血管造影评价颈动脉狭窄急性脑梗死患者颈动脉低密度斑块与复发性脑血管事件的关系。方法:选取2020年5月—2021年5月南昌市洪都中医院收治的86例首次诊断为颈动脉狭窄急性脑梗死并经彩超证实有低密度斑块的患者。所有患者均行CT血管造影,并随访1年。分析患者一般临床资料、不良习惯、合并症、颈动脉低密度斑块信息与复发性脑血管事件的关系,采用多因素logistic回归分析复发性脑血管事件的影响因素。结果:随访1年中,26例(30.23%)发生复发性脑血管事件,为复发组,60例(69.77%)未发生复发性脑血管事件,设为未复发组。单因素分析结果显示,两组高血压、糖尿病、血管狭窄程度、斑块长度、斑块负荷、斑块强化程度、斑块内出血比较,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,斑块长度[OR=6.630,95%CI(1.720,25.575),P=0.006]、斑块负荷[OR=2.748,95%CI(1.357,5.568),P=0.005]、斑块强化2级[OR=3.271,95%CI(1.215,8.804),P=0.019]均是影响复发性脑血管事件的独立危险因素。ROC曲线结果显示,3个危险因素联合的AUC为0.965,95%CI(0.931,0.999),敏感度为100%,特异度为80.00%。结论:颈动脉斑块的长度、负荷及斑块强化2级均是影响复发性脑血管事件的独立危险因素,采用CT血管造影观察患者颈动脉斑块特征对评估患者复发性脑血管事件的发生率有重要价值。Objective:To explore the relationship between carotid artery low-density plaque and recurrent cerebrovascular events in patients with acute cerebral infarction of carotid artery stenosis based on CT angiography.Method:A total of 86 acute cerebral infarction patients with carotid artery stenosis and low-density plaque confirmed by color ultrasound were selected from May 2020 to May 2021 in Nanchang Hongdu Hospital of TCM.All patients underwent CT angiography and were followed up for 1 year.The relationship between the general clinical data,bad habits,comorbidities,carotid artery low-density plaque information and recurrent cerebrovascular events were analyzed.The influencing factors of early recurrent cerebrovascular events were analyzed by multivariate logistic regression.Result:During 1 year follow up,26 cases(30.23%)had recurrent cerebrovascular events were set up as the recurrent group,while 60 cases(69.77%)had no recurrent cerebrovascular events were set up as the non-recurrent group.The results of single factor analysis showed that there were statistically significant differences in hypertension,diabetes mellitus,degree of vascular stenosis,plaque length,plaque load,degree of plaque enhancement and intra-plaque bleeding between the two groups(P<0.05).Multivariate logistic regression analysis showed that plaque length[OR=6.630,95%CI(1.720,25.575),P=0.006],plaque load[OR=2.748,95%CI(1.357,5.568),P=0.005]and plaque enhancement grade 2[OR=3.271,95%CI(1.215,8.804),P=0.019]were independent risk factors of recurrent cerebrovascular events.ROC curve results showed that the combined three risk factors of AUC was 0.965,95%CI(0.931,0.999),sensitivity was 100%,specificity was 80.00%.Conclusion:The length,load of carotid artery plaque and plaque enhancement grade 2 are independent risk factors of recurrent cerebrovascular events,CT angiography to observe the characteristics of carotid plaque in patients is of great value in evaluating the incidence of recurrent cerebrovascular events.

关 键 词：颈动脉狭窄 低密度斑块 CT血管造影 复发性脑血管事件 

分 类 号：R743.33[医药卫生—神经病学与精神病学]