颈动脉斑块超声联合埃森卒中风险评分量表预测缺血性脑卒中发生风险的研究  

Carotid Plaque Ultrasound Combined with Essen Stroke Risk Score to Predict Risk of Ischemic Stroke

作　　者：金志瑛 李俊康 姜莹 李诗雨 牛瑞兰 付乃芹 王知力[1] Jin Zhiying;Li Junkang;Jiang Ying;Li Shiyu;Niu Ruilan;Fu Naiqin;Wang Zhili(Department of Ultrasound,The First Medical Center of the PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心超声诊断科,北京市100853

出　　处：《中国超声医学杂志》2024年第11期1208-1212,共5页Chinese Journal of Ultrasound in Medicine

基　　金：军队后勤自主科研项目(No.2022hqky02);军队保健专项科研课题(No.24BJZ17)。

摘　　要：目的探讨颈动脉斑块二维超声及超声造影联合埃森卒中风险评分量表(ESRS)预测缺血性脑卒中(IS)发生风险的价值。方法回顾性收集行颈动脉斑块二维超声及超声造影检查的974例患者的临床信息和超声图像。根据临床诊断分为IS组和无IS组,分析对比两组斑块的超声特征,结合ESRS建立基于多因素Logistic回归的预测模型,绘制受试者工作特征曲线评估模型价值。结果其中,IS组519例,无IS组455例。多因素分析结果表明,斑块最大厚度、狭窄程度及新生血管分级是IS发生的独立危险因素。二维超声、超声造影、ESRS以及三者联合的风险预测模型曲线下面积(AUC)分别为0.823、0.810、0.705、0.910。结论超声评估颈动脉斑块对预测IS具有一定的价值,超声联合ESRS为颈动脉粥样硬化患者临床管理提供了新的参考。Objective To investigate the value of two-dimensional ultrasound(2D-US)and contrast enhanced ultrasound(CEUS)of carotid plaque combined with the Essen stroke risk score(ESRS)in predicting the risk of ischemic stroke(IS).Methods In this study,the clinical information and ultrasound images of 974 patients who underwent 2D-US and CEUS examination of carotid plaque were retrospectively collected.The patients were divided into the IS group and the stroke free group according to whether IS occurred.The ultrasound characteristics of the two groups were analyzed and compared.Combined with ESRS,a prediction model based on multivariate Logistic regression was established.The receiver operating characteristic(ROC)curve was drawn to evaluate the value of the model.Results There were 519 cases in the IS group and 455 cases in the stroke free group.The results of multi-factor analysis showed that the maximum thickness of plaque,the degree of stenosis and the stenosis degree and neovascularization were independent risk factors for the occurrence of IS.The areas under the curves(AUCs)of the risk prediction models for 2D-US,CEUS,ESRS and the combination of the three were 0.823,0.810,0.705,and 0.910,respectively.Conclusions Ultrasound assessment of carotid plaque have certain value in predicting IS,and ultrasound combined with ESRS provides a new reference for the clinical management of patients with carotid atherosclerosis.

关 键 词：颈动脉斑块 超声 缺血性脑卒中 埃森卒中风险评分量表 

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]