糖尿病合并高血压患者颈动脉斑块超声参数与缺血性卒中的相关性分析  

Correlation between carotid plaque ultrasound parameters and ischemic stroke in diabetes patients with hypertension

作　　者：刘阿楠 董德晟 LIU A-nan;DONG De-sheng(Department of Neurology,the First Peoples Hospital of Pingdingshan,Pingdingshan,Henan 467000,China)

机构地区：[1]平顶山市第一人民医院神经内科,河南平顶山467000

出　　处：《医药论坛杂志》2024年第20期2208-2212,共5页Journal of Medical Forum

摘　　要：目的分析糖尿病合并高血压患者颈动脉粥样硬化超声参数与缺血性卒中的相关性。方法选取平顶山市第一人民医院2022年2月至2023年12月诊治的糖尿病合并高血压的缺血性卒中患者64例,以1∶2的比例为每例缺血性卒中患者匹配2例无卒中的糖尿病合并高血压患者作为对照,无卒中组共128例。比较两组临床和超声资料,分析颈动脉斑块大小(carotid plaque size,CPS)、颈动脉内膜中层厚度(carotid intima-media thickness,CIMT)、阻力指数(resistance index,RI)、搏动指数(pulsatility index,PI)与糖尿病、高血压参数,以及缺血性卒中的相关性。结果卒中组患者糖尿病和高血压病程长于无卒中组,存在斑块比率、收缩压(systolic blood pressure,SBP)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、空腹血糖(fasting blood glucose,FBG)、CIMT、CPS、RI和PI均高于无卒中组。CIMT、CPS、RI和PI与SBP和HbA1c呈正相关。logistic回归显示,较高的CIMT、CPS、RI和PI是患者出现缺血性卒中的相关因素。CIMT、CPS、RI和PI的受试者工作曲线(receiver operating character,ROC)的曲线下面积(area under the curve,AUC)分别为0.624、0.739、0.641和0.657,CPS与CIMT、RI和PI的ROC比较差异有统计学意义,预测价值最高。结论颈动脉斑块超声参数是糖尿病合并高血压患者缺血性卒中的相关因素,其中CPS对缺血性卒中有较高的预测价值。Objective To analyze the correlation between carotid plaque ultrasound parameters and ischemic stroke in patients with diabetes mellitus and hypertension.Methods Totally 64 patients with diabetes mellitus complicated with hypertension who were diagnosed and treated from February 2022 to December 2023 in the First People's Hospital of Pingdingshan were selected,and 2 patients with diabetes mellitus complicated with hypertension without stroke were matched with each patient with ischemic stroke in the ratio of 1∶2 as the control,with 128 cases in the non stroke group.The clinical and ultrasound data of the two groups were compared,and the correlation of carotid plaque size(CPS),carotid intima-media thickness(CIMT),resistance index(RI),pulsatility index(PI)with diabetes,hypertension parameters,and ischemic stroke was analyzed.Results The duration of diabetes and hypertension in the stroke group was longer than that in the non stroke group,and the plaque ratio,systolic blood pressure(SBP),glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG),CIMT,CPS,RI and PI in the stroke group were higher than those in the non stroke group.CIMT,CPS,RI and PI were positively correlated with SBP and HbA1c.Logistic regression showed that higher CIMT,CPS,RI and PI were the related factors of ischemic stroke.The area under the receiver operating characteristic(ROC)curve of CIMT,CPS,RI and PI were 0.624,0.739,0.641 and 0.657,respectively.The ROC of CPS was significantly different from CIMT,RI and PI,with the highest predictive value.Conclusion Carotid plaque ultrasound parameters are related factors of ischemic stroke in patients with diabetes mellitus and hypertension,and CPS has high predictive value for ischemic stroke.

关 键 词：颈动脉粥样硬化 颈动脉超声 缺血性卒中 糖尿病 高血压 

分 类 号：R541.4[医药卫生—心血管疾病]