颈动脉狭窄的彩色多普勒超声特征与缺血性脑卒中病发的关联研究  

Study on the correlation between Doppler ultrasound features of carotid artery stenosis and the incidence of ischemic stroke

作　　者：巩远方 陈平 张昊 段朋仓 张书研 温永飞 王智培 GONG Yuanfang;CHEN Ping;ZHANG Hao;DUAN Pengcang;ZHANG Shuyan;WEN Yongfei;WANG Zhipei(Department of Ultrasound,Cangzhou People's Hospital,Cangzhou 061000,China;Department of Cardiology,Cangzhou People's Hospital,Cangzhou 061000,China;Department of Respiratory and Critical Care Medicine,Cangzhou People's Hospital,Cangzhou 061000,China)

机构地区：[1]河北省沧州市人民医院超声科,河北沧州061000 [2]河北省沧州市人民医院心内二科,河北沧州061000 [3]河北省沧州市人民医院呼吸与危重症医学科,河北沧州061000

出　　处：《医学影像学杂志》2024年第9期19-23,共5页Journal of Medical Imaging

基　　金：河北省医学科学研究课题计划项目(编号:20211564)。

摘　　要：目的探讨颈动脉彩色多普勒超声评估颈动脉狭窄(CAS)患者超声检查特征与患者缺血性脑卒中(CIS)病发的关联性。方法选取本院收治的CAS患者106例临床资料行回顾性分析,根据近期6个月同侧同流域CIS症状发生情况分为症状组(n=46)和无症状组(n=60),通过单因素方差分析两组一般资料与超声检查特征的差异,并将有统计学差异的指标纳入二元Logistic回归模型分析中,分析CIS症状发生相关影响因素。通过ROC曲线分析CAS患者超声检查特征预测CIS病发的价值。结果症状组颈动脉狭窄率(70%~99%)、斑块表面形态(不规则)、斑块内新生血管分级(Ⅰ级~Ⅱ级)高于无症状组,差异有统计学意义(P<0.05)。二元Logistic回归分析显示,颈动脉狭窄率(70%~99%)、斑块表面形态(不规则)、斑块内新生血管分级(Ⅰ~Ⅱ级)是CAS患者发生缺血性脑卒中的危险因素(P<0.05)。ROC曲线分析显示,颈动脉狭窄患者超声检查特征(颈动脉狭窄率、斑块表面形态、斑块内新生血管分级)预测CIS发生的AUC分别为0.611、0.740、0.836,敏感度为52.2%、91.3%、78.3%,特异度为70.0%、56.7%、90.0%,预测具有一定价值。结论颈动脉彩色多普勒超声评估CAS的超声检查特征可作为预测CIS病发的有效指标。Objective To explore the association between the ultrasonic characteristics of carotid artery stenosis(CAS)patients and the incidence of ischemic stroke(CIS)patients assessed by carotid color Doppler ultrasound.Methods Clinical data of 106 CAS patients admitted to our hospital were retrospectively analyzed,and those patients were divided into symptomatic group(n=46)and asymptomatic group(n=60)according to the incidence of CIS symptoms on the same side and in the same basin in the recent 6 months.Differences in general data and ultrasound characteristics between the two groups were analyzed by one-way variance.The indicators with statistical differences were included in the analysis of binary Logistic regression model to analyze the related influencing factors of CIS symptoms.ROC curve was used to analyze the value of ultrasonic characteristics of CAS patients in predicting the incidence of CIS.Results The rate of carotid artery stenosis(70%-99%),the surface morphology of plaque(irregular)and the classification of neovascularization in plaque(gradeⅠ~Ⅱ)in symptomatic group were higher than those in asymptomatic group(P<0.05).Binary Logistic regression analysis showed that carotid artery stenosis rate(70%~99%),plaque surface morphology(irregular),and intra-plaque neovascularization grade(gradeⅠ~Ⅱ)were risk factors for ischemic stroke in CAS patients(P<0.05).ROC curve analysis showed that the AUC of CIS prediction for carotid artery stenosis patients(carotid artery stenosis rate,plaque surface morphology,and intra-plaque neovasculation)was 0.611,0.740,and 0.836,respectively,with sensitivity of 52.2%,91.3%,and 78.3%.The specificity was 70.0%,56.7%,90.0%,which had certain value in prediction.Conclusion The ultrasonic characteristics of CAS assessed by carotid color Doppler ultrasound can be used as an effective index to predict the incidence of CIS.

关 键 词：缺血性脑卒中 颈动脉狭窄 彩色多普勒超声 预测 

分 类 号：R743.1[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]