颈动脉斑块超声特征与缺血性脑卒中的关系  

Relationship between ultrasonic features of carotid plaque and ischemic stroke

作　　者：张微[1] 姜阳[1] 许丽华[2] Zhang Wei;Jiang Yang;Xu Lihua(Department of Ultrasound,the Central Hospital of Jiamusi City,Jiamusi 154002,Heilongjiang,China;Department of Neurology,the Central Hospital of Jiamusi City,Jiamusi 154002,Heilongjiang,China)

机构地区：[1]佳木斯中心医院超声科,黑龙江佳木斯154002 [2]佳木斯中心医院神经内科,黑龙江佳木斯154002

出　　处：《血管与腔内血管外科杂志》2024年第4期489-493,共5页Journal of Vascular and Endovascular Surgery

基　　金：黑龙江省卫生健康委科研课题立项(20220303071156)。

摘　　要：目的探讨颈动脉斑块超声特征与发生缺血性脑卒中的关系。方法收集2023年1—12月于佳木斯中心医院就诊的49例颈动脉斑块患者的临床资料,均进行颈动脉超声检查及颅脑磁共振成像(MRI)检查,观察颈动脉内中膜(IMT)是否增厚,有无斑块形成,评估颈动脉斑块的数量、位置、回声特征及大小,采用多因素Logistic回归模型分析颈动脉斑块特征与发生缺血性脑卒中的关系。结果颈动脉斑块厚度1.5~4.6 mm,平均厚度(2.68±0.81)mm;斑块长度5.0~62.0 mm,平均长度(15.77±9.34)mm。颈动脉斑块多位于颈总动脉分叉处和颈内动脉起始段,回声类型以混合回声为主[52.81%(47/89)]。缺血性脑卒中组的颈动脉斑块厚度、强回声斑块数量均高于非缺血性脑卒中组,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,颈动脉斑块厚度增加、强回声均是发生缺血性脑卒中的危险因素(P﹤0.05)。受试者工作特征(ROC)曲线分析显示,颈动脉斑块厚度预测缺血性脑卒中的曲线下面积(AUC)为0.752(95%CI:0.650~0.853),最佳预测截断值为3.4 mm,灵敏度为47.5%,特异度为91.8%。结论超声检查能够有效评估颈动脉斑块的特征,颈动脉斑块的厚度、位置以及斑块回声与缺血性脑卒中的发生密切相关,综合评估颈动脉斑块超声特征对脑梗死的预防和管理具有重要的临床意义。Objective To investigate the relationship between the ultrasonic features of carotid plaque and ischemic stroke.Method The clinical data of 49 patients with carotid plaque admitted to the Central Hospital of Jiamusi City from January to December 2023 were collected.Carotid artery ultrasonography and craniocerebral magnetic resonance imaging(MRI)were performed to observe whether carotid intima-media(IMT)thickened and whether there was plaque formation,the number,location,echo characteristics and size of carotid plaques were evaluated.Multivariate Logistic regression model was used to analyze the relationship between carotid plaque characteristics and ischemic stroke.Result The carotid plaque thickness was 1.5-4.6 mm,and the average thickness was(2.68±0.81)mm.The patch length was 5.0-62.0 mm,with an average length of(15.77±9.34)mm.Carotid plaque was mostly located in the common carotid artery bifurcation and the initial section of internal carotid artery,and the echo type was mainly mixed echo[52.81%(47/89)].The carotid plaque thickness and the number of strong echo plaques in ischemic stroke group were higher than those in non-ischemic stroke group,the differences were statistically significant(P<0.05).The results of multi-factor analysis showed that the increase of carotid plaque thickness and strong echo were risk factors for ischemic stroke(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of carotid plaque thickness for predicting ischemic stroke was 0.752(95%CI:0.650-0.853),the best predictive cutoff value was 3.4 mm,the sensitivity was 47.5%,and the specificity was 91.8%.Conclusion Ultrasound examination can effectively evaluate the characteristics of carotid plaque,the thickness,location and echo of carotid plaque are closely related to the occurrence of ischemic stroke.Comprehensive evaluation of carotid plaque ultrasound features has important clinical significance for the prevention and management of cerebral infarction.

关 键 词：颈动脉斑块 超声特征 缺血性脑卒中 

分 类 号：R543[医药卫生—心血管疾病]