全息血管硬度分析技术在首发腔隙性脑梗死及短暂性脑缺血发作患者颈总动脉僵硬评估中价值  

Radio frequency-data based quantitative analysis of vessel stiffness in evaluating common carotid artery stiffness of patients with first lacunar infarction and transient ischemic attack

作　　者：董强利 卜豪英 陈屏[1] 蔡丹灵[1] 韩苗苗 黄娇娇 吴铭 DONG Qiangli;BU Haoying;CHEN Ping;CAI Danling;HAN Miaomiao;HUANG Jiaojiao;WU Ming(Department of Ultrasound,Yellow River Central Hospital,Zhengzhou,Henan 450003,China;Department of Neurology,Yellow River Central Hospital,Zhengzhou,Henan 450003,China;Department of Ultrasound,Henan Provincial People's Hospital,Zhengzhou University People's Hospital,Zhengzhou,Henan 450003,China)

机构地区：[1]黄河中心医院超声科,河南郑州450003 [2]黄河中心医院神经内科,河南郑州450003 [3]河南省人民医院郑州大学人民医院超声科,河南郑州450003

出　　处：《中华实用诊断与治疗杂志》2023年第11期1166-1170,共5页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20220703)。

摘　　要：目的应用全息血管硬度分析技术(R-QVS)检测首发腔隙性脑梗死(LI)及短暂性脑缺血发作(TIA)患者颈总动脉血管弹性参数,探讨影响LI、TIA患者颈总动脉脉搏波传导速度(PWV)的影响因素。方法2022年8月—2023年5月黄河中心医院和河南省人民医院就诊首发LI患者47例为LI组,TIA患者43例为TIA组,同期体检健康者52例为对照组。LI、TIA患者于入院次日、对照组于体检时行超声检查,在颈内、外动脉分叉水平下方1~2cm范围内测量颈总动脉远段后壁内-中膜厚度(IMT),采用R-QVS测量颈总动脉远段血管收缩期管腔内径(Diam)、血管壁位移(Dist)、硬度指数(HC)和PWV。收集LI、TIA患者入院次日及对照组空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(APOA1)、载脂蛋白B100(APOB100)、同型半胱氨酸(Hcy)水平;采用Pearson相关法分析TIA组、LI组颈总动脉IMT、Diam、HC、PWV与收缩压、脉压等的相关性;采用多元线性回归分析影响TIA组、LI组患者PWV的因素。结果(1)3组颈总动脉IMT、Diam、HC、PWV比较差异均有统计学意义(P<0.05),Dist比较差异无统计学意义(P>0.05)。LI组IMT[(0.74±0.09)mm]、Diam[(7.44±0.66)mm]、HC(4.00±0.92)、PWV[(7.77±0.89)m/s]均高于TIA组[(0.68±0.13)mm、(7.09±0.52)mm、3.49±0.90、(6.93±1.11)m/s]和对照组[(0.65±0.85)mm、(6.87±0.33)mm、3.27±0.56、(6.53±0.73)m/s](P<0.05);TIA组PWV高于对照组(P<0.05)。(2)3组收缩压、脉压及血清HDL-C、Hcy水平比较差异均有统计学意义(P<0.05),舒张压、FPG及血清TC、TG、LDL-C、APOA1、APOB100水平比较差异均无统计学意义(P>0.05)。LI组收缩压、脉压及血清Hcy水平均高于TIA组和对照组(P<0.05),血清HDL-C水平低于对照组(P<0.05);TIA组收缩压、脉压均高于对照组(P<0.05)。(3)LI组、TIA组收缩压、脉压、Hcy与HC、PWV均呈正相关(P<0.05),LI组HDL-C与HC、PWV均呈负相关(P<0.Objective To measure the common carotid artery elastic parameters with radio frequency-data based quantitative analysis of vessel stiffness(R-QVS)in patients with first lacunar infarction(LI)and transient ischemic attack(TIA),and to investigate the influencing factors of pulse wave velocity(PWV)of common carotid artery in patients with first LI and TIA.Methods From August 2022 to May 2023 in Yellow River Central Hospital and Henan Provincial People's Hospital,47 patients with first LI(LI group),43 patients with TIA(TIA group)groups and 52healthy volunteers in the same period(control group)were enrolled.LI and TIA groups on the next day after admission,and control group during physical examination received ultrasound examination.The posterior wall intima-media thickness(IMT)of the distal common carotid artery was measured within 1 to 2 cm below the level of the internal and external carotid artery bifurcation.R-QVS was used to measure the distal carotid artery systolic lumen diameter(Diam),wall displacement(Dist),hardness coefficient(HC)and PWV.The levels of fasting plasma glucose(FPG),total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein A_1(APOA1),apolipoprotein B100(APOB100)and homocysteine(Hcy)were detected in three groups on the day after admission.Pearson correlation was used to analyze the correlations of IMT,Diam,HC and PWV of common carotid artery with systolic blood pressure(SBP)and pulse pressure in TIA and LI groups.Multiple linear regression was used to analyze the influencing factors of PWV in TIA and LI groups.Results(1)There were significant differences in the IMT,Diam,HC and PWV of common carotid artery among three groups(P<0.05),while Dist showed no significant difference among three groups(P>0.05).IMT,Diam,HC and PWV were higher in LI group[(0.74±0.09)mm,(7.44±0.66)mm,4.00±0.92,(7.77±0.89)m/s]than those in TIA group[0.68±0.13)mm,(7.09±0.52)mm,3.49±0.90,(6.93±1.11)m/s]and control group[(0.65±0.85)mm

关 键 词：腔隙性脑梗死 短暂性脑缺血发作 全息血管硬度分析技术 超声检查 颈总动脉僵硬 脉搏波传导速度 

分 类 号：R743.33[医药卫生—神经病学与精神病学]