股总动脉斑块稳定性联合颈动脉斑块最大厚度检测对老年急性脑梗死复发的预测价值  

Predictive value of common femoral artery plaque stability combined with carotidartery plaque maximal thickness for recurrence of acute cerebral infarction in elderly

作　　者：苗涛 卫国 赵清 MIAO Tao;WEI Guo;ZHAO Qing(The First Affiliated Hospital of Air Force Medical University,Xi’an 710032,China)

机构地区：[1]空军军医大学第一附属医院,陕西西安710032 [2]空军军医大学空军第九八六医院干部病房,陕西西安710054

出　　处：《陕西医学杂志》2025年第1期57-61,共5页Shaanxi Medical Journal

基　　金：陕西省重点研发计划项目(2023-YBSF-512)。

摘　　要：目的:探讨股总动脉斑块稳定性联合颈动脉斑块最大厚度对老年急性脑梗死复发的预测价值。方法:前瞻性选择256例老年急性脑梗死患者为研究对象,按照发病后1年内是否复发分为复发组和未复发组。收集所有患者基线资料与超声指标,采用非条件二分类Logistic回归分析影响脑梗死复发的相关因素。绘制受试者工作特征(ROC)曲线分析此类超声指标对脑梗死复发的预测价值。结果:与非复发组比较,复发组糖尿病史、入院卒中量表(NIHSS)评分、收缩压、低密度脂蛋白胆固醇(LDL-C)、C反应蛋白、D-二聚体、股总动脉斑块易损评分、股总动脉颈动脉内中膜厚度(IMT)、颈动脉斑块最大厚度、颈动脉IMT均较高,差异有统计学意义(均P<0.05)。多因素Logistic回归分析显示,股总动脉斑块易损评分、颈动脉斑块最大厚度是影响老年急性脑梗死复发的独立危险因素(均P<0.05)。ROC分析显示,股总动脉斑块易损评分、颈动脉斑块最大厚度预测脑梗死复发的曲线下面积(AUC)分别为0.752,0.814,灵敏度分别为69.28%和77.80%;特异度分别为84.35%和82.82%,最佳诊断值分别为4.65分和2.78 mm。两者联合预测的AUC为0.903,明显高于前两者(均P<0.05)。结论:股总动脉斑块稳定性、颈动脉斑块最大厚度与老年急性脑梗死复发具有相关性,两者联合检测对脑梗死复发具有良好的预测价值,有助于脑梗死复发的高危人群进行鉴别和危险分层。Objective:To investigate the predictive value of common femoral artery plaque stability combined with carotid plaque maximal thickness in the recurrence of acute cerebral infarction in the elderly.Methods:A total of 256 elderly patients with acute cerebral infarction were prospectively selected and divided into recurrence group and non-recurrence group according to whether they recurred within 1 year after the onset of the disease.The baseline data and ultrasound indexes of all patients were collected,and the related factors affecting the recurrence of cerebral infarction were analyzed by non-conditional dichotomous Logistic regression.The ROC curve was plotted to analyze the predictive value of such ultrasound indicators for cerebral infarction recurrence.Results:Compared with the non-recurrence group,the recurrence group had a statistically significant difference in diabetes history,admission NIHSS score,systolic blood pressure,LDL-C,C-reactive protein,D-dimer,common femoral artery plaque vulnerability score,common femoral artery IMT,carotid plaque maximum thickness,and carotid artery IMT(all P<0.05).Multivariate Logistic regression analysis showed that the common femoral artery plaque vulnerability score and maximum carotid plaque thickness were independent risk factors for recurrence of acute cerebral infarction in the elderly(all P<0.05).ROC analysis showed that the AUC of common femoral artery plaque fragility score and carotid artery plaque thickness in predicting recurrence of cerebral infarction were 0.752 and 0.814,respectively,the sensitivity and specificity were 84.35%and 82.82%,respectively,and the optimal cut-off value was 4.65 points and 2.78 mm.The ROC of the two joint predictions was 0.903,which was significantly higher than the first two(all P<0.05).Conclusion:The stability of common femoral artery plaque and the maximum thickness of carotid artery plaque are correlated with the recurrence of acute cerebral infarction in the elderly,and the combined detection of the two has a good predictive val

关 键 词：股总动脉斑块稳定性 颈动脉斑块最大厚度 脑梗死 复发 预测价值 老年人 

分 类 号：R543.5[医药卫生—心血管疾病]