颈动脉斑块负荷联合超声定量参数在评估急性脑梗死患者神经功能缺损程度中的应用价值  

The application value of carotid artery plaque load combined with quantitative ultrasound parameters in evaluating the degree of neurological deficits in acute cerebral infarction patients

作　　者：刘月 骈林萍[1] 李超[1] 田婧[1] 张红丽 闫海峰 顾腾辉 Liu Yue;Pian Linping;Li Chao;Tian Jing;Zhang Hongli;Yan Haifeng;Gu Tenghui(Department of Ultrasound,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院超声科,河南郑州450000 [2]河南中医药大学第一附属医院心血管病科,河南郑州450000 [3]开封市中心医院医学影像科,河南开封475000

出　　处：《中国急救医学》2024年第12期1029-1035,共7页Chinese Journal of Critical Care Medicine

基　　金：河南省中医药科学研究专项课题(2022JDZX128)。

摘　　要：目的探讨颈动脉斑块负荷联合超声定量参数在评估急性脑梗死(ACI)患者神经功能缺损程度中的应用价值。方法选取2020年1月至2023年1月河南中医药大学第一附属医院收治的106例ACI患者作为研究对象,所有患者均接受彩色多普勒超声检查。采用国立卫生研究院卒中量表(NIHSS)评估ACI患者神经功能缺损程度,并以此分为轻度缺损组、中度缺损组及重度缺损组。比较不同组别ACI患者颈动脉斑块负荷指标与超声定量参数,使用Pearson相关性检验颈动脉斑块负荷指标、超声定量参数与患者NIHSS评分的相关性;绘制受试者工作特征(ROC)曲线分析颈动脉斑块负荷指标联合超声定量参数对ACI患者神经功能缺损程度的评估价值。结果106例ACI患者中,轻度、中度缺损组各35例,重度缺损组36例。重度缺损组斑块厚度、管壁面积、血管总面积及标准化管壁指数(NWI)高于中度、轻度缺损组,且中度缺损组高于轻度缺损组,差异均有统计学意义(P<0.05);重度缺损组管腔面积低于中度、轻度缺损组,中度缺损组低于轻度缺损组,差异均有统计学意义(P<0.05)。重度缺损组颈总动脉内膜中层厚度(IMT)、舒张末期血流速度(EDV)高于中度、轻度缺损组,中度缺损组高于轻度缺损组,差异均有统计学意义(P<0.05);重度缺损组颈总动脉收缩期峰值血流速度(PSV)低于中度、轻度缺损组,中度缺损组低于轻度缺损组,差异均有统计学意义(P<0.05)。Pearson相关性检验显示,斑块厚度、管壁面积、血管总面积、NWI、IMT、EDV与NIHSS评分呈正相关(r>0,P<0.05),PSV、管腔面积与NIHSS评分呈负相关(r<0,P<0.05)。绘制ROC曲线,结果显示,颈动脉斑块负荷指标联合超声定量参数对中度、重度神经功能缺损均有较高的评估价值,曲线下面积(AUC)分别为0.936、0.987。结论颈动脉斑块负荷联合超声定量参数可有效评估ACI患者的神经功能缺损程度。Objective To explore the application value of carotid artery plaque load combined with quantitative ultrasound parameters in evaluating the degree of neurological deficits in the patients with acute cerebral infarction(ACI).Methods A prospective study was conducted on 106 ACI patients admitted to the First Affiliated Hospital of Henan University of Chinese Medicine from January 2020 to January 2023 as the research subjects.All the patients underwent color Doppler ultrasound examination.The national institutes of health stroke scale(NIHSS)was used to evaluate the degree of neurological deficits in ACI patients who were divided into mild deficit group,moderate deficit group and severe deficit group.The carotid plaque load index and quantitative ultrasound parameters of patients in different groups were compared.Pearson correlation was used to test the correlation of carotid plaque load index and quantitative ultrasound parameters with NIHSS score of patients.Receiver operating characteristic(ROC)curve was drawn to analyze the value of carotid plaque load index combined with quantitative ultrasound parameters in evaluating the degree of neurological deficits in ACI patients.Results According to the NIHSS evaluation results,there were 35 cases in the mild and moderate deficit groups and 36 cases in the severe deficit group among the 106 patients.The plaque thickness,vessel wall area,total vascular area and normalized wall index(NWI)in the severe deficit group were higher than those in the moderate and mild deficit groups,and the moderate deficit group was higher than the mild deficit group with statistically significant differences(P<0.05).The lumen area of the severe deficit group was lower than that of the moderate and mild deficit groups,and the moderate deficit group was lower than the mild deficit group with a statistically significant difference(P<0.05).The intima-media thickness(IMT)and end diastolic blood flow velocity(EDV)of the common carotid artery in the severe deficit group were higher than those in the

关 键 词：急性脑梗死 斑块厚度 管壁面积 血管总面积 标准化管壁指数 颈总动脉内膜中层厚度 舒张末期血流速度 收缩期峰值血流速度 

分 类 号：R445.1[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]