颈部血管超声参数联合血压变异性参数对老年高血压脑出血患者预后的预测价值  

Predictive value of cervical vascular ultrasound parameters combined with blood pressure variability parameters for the prognosis of elderly patients with hypertensive cerebral hemorrhage

作　　者：孙艳芳 孔文韬 丁广贵 Sun Yanfang;Kong Wentao;Ding Guanggui(Department of Ultrasound Diagnosis,Mingguang People's Hospital,Chuzhou 239400,Anhui,China;Department of Ultrasound Medicine,Nanjing Gulou Hospital,Nanjing 210003,Jiangsu,China;Department of Geriatrics,Mingguang People's Hospital,Chuzhou 239400,Anhui,China)

机构地区：[1]明光市人民医院超声诊断科,安徽滁州239400 [2]南京鼓楼医院超声医学科,江苏南京210003 [3]明光市人民医院老年医学科,安徽滁州239400

出　　处：《血管与腔内血管外科杂志》2024年第8期974-978,996,共6页Journal of Vascular and Endovascular Surgery

基　　金：江苏省第十四批“六大人才高峰”高层次人才选拔培养资助项目(WSW-076)。

摘　　要：目的探讨颈部血管超声参数联合血压变异性参数对老年高血压脑出血患者预后的预测价值。方法收集2022年1月至2024年1月明光市人民医院收治的80例老年高血压脑出血患者的临床资料。依据术后3个月时的格拉斯哥昏迷评分(GCS)将患者分为预后良好组(n=55,GCS为4~5分)和预后不良组(n=25,GCS为1~3分)。所有患者术前均接受颈部血管超声检查和血压变异性检查。比较两组患者的术前颈部血管超声参数[椎动脉颅外段(VA)管径、阻力指数(RI)、颈总动脉(CCA)管径、颈内动脉颅外段(ICA)管径]和术后16 h的血压变异性参数[收缩压(SBP)、舒张压(DBP)、收缩压变异系数(SCV)、舒张压变异系数(DCV)]。分析老年高血压脑出血患者预后的危险因素,采用受试者工作特征(ROC)曲线分析颈部血管超声参数和血压变异性参数单独及联合检测对老年高血压脑出血患者预后的预测价值。结果颈部血管超声检查结果显示,预后不良组患者的VA管径低于预后良好组患者,RI、术后16 h SCV、术后16 h DCV均高于预后良好组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,较高的RI、术后16 h SCV和术后16 h DCV均是老年高血压脑出血患者预后不良的独立危险因素(P﹤0.05)。ROC曲线分析结果显示,RI、术后16 h SCV和术后16 h DCV对老年高血压脑出血患者的预后均具有良好的预测价值,且三者联合应用的预测价值更高,曲线下面积(AUC)为0.846(P﹤0.05)。结论较高的RI、术后16 h SCV和术后16 h DCV均是老年高血压脑出血患者预后不良的独立危险因素,三者均对老年高血压脑出血患者的预后具有较高的预测价值,但三者联合检测的预测价值更高。Objective To investigate the predictive value of cervical vascular ultrasound parameters combined with blood pressure variability parameters for the prognosis of elderly patients with hypertensive cerebral hemorrhage.Method The clinical data of 80 elderly patients with hypertensive cerebral hemorrhage admitted to Mingguang People's Hospital from January 2022 to January 2024 were collected.According to the scores of Glasgow coma scale(GCS)at 3 months after surgery,the patients were divided into good prognosis group(n=55,GCS scores of 4-5)and poor prognosis group(n=25,GCS scores of 1-3).All patients underwent examinations of cervical vascular ultrasound and blood pressure variability before surgery.The preoperative cervical vascular ultrasound parameters[vertebral artery(VA)diameter,resistance index(RI),common carotid artery(CCA)diameter,internal carotid artery(ICA)diameter],and postoperative blood pressure variability parameters[systolic blood pressure(SBP),diastolic blood pressure(DBP),systolic coefficient of variation(SCV),diastolic blood coefficient of variation(DCV)]at 16 h after surgery between two groups of patients were compared.The risk factors for prognosis in elderly patients with hypertensive cerebral hemorrhage was analyzed,and the predictive value of cervical vascular ultrasound parameters combined with blood pressure variability parameters for the prognosis of elderly patients with hypertensive cerebral hemorrhage was analyzed by receiver operator characteristic(ROC)curve.Result The results of neck vascular ultrasound examination showed that the VA diameter of patients in the poor prognosis group was lower than that of patients in the good prognosis group,and RI,SCV at 16 h after surgery,and DCV at 16 h after surgery were all higher than those of patients in the good prognosis group,and the differences were statistically significant(P<0.05).The results of multivariate analysis showed that higher RI,SCV at 16 h after surgery,and DCV at 16 h after surgery were all independent risk factors for poor prog

关 键 词：颈部血管超声参数 血压变异性 高血压脑出血 预后 

分 类 号：R543[医药卫生—心血管疾病]