颈脑动脉一体化超声在脑卒中高危人群中的应用  

Application of Integrated Carotid Cerebral Artery Ultrasound for High-risk Populations with Stroke

作　　者：周江鑫 翁智渊 赖梅平 张宜珍 陈献明[1] ZHOU Jiangxin;WENG Zhiyuan;LAI Meiping;ZHANG Yizhen;CHEN Xianming(Shenzhen City Bao'an District Songgang People's Hospital,Shenzhen,Guangdong 518105)

机构地区：[1]深圳市宝安区松岗人民医院,广东深圳518105

出　　处：《智慧健康》2024年第32期7-9,17,共4页Smart Healthcare

基　　金：深圳市宝安区科技计划基础研究项目(医疗卫生类)《颈脑动脉一体化超声在脑卒中高危人群中的应用》(项目编号:2021JD314)。

摘　　要：目的探究在脑卒中高危人群中采用颈脑动脉一体化超声的临床应用价值。方法选取2021年1月—2023年4月本院门诊及体检科的256例脑卒中高危患者为研究对象,参与研究的患者均采取颈脑动脉一体化超声检查,并就患者年龄、性别、颈动脉斑块形成的单因素及多因素进行Logistic回归分析。结果60岁及60岁以上的脑血管病患者比40~60岁的患者更易患有内膜增厚、斑块形成、颈动脉阻塞或狭窄、颅内椎基底动脉狭窄或闭塞(P<0.05);而不同年龄组的脑中动脉狭窄和阻塞比较,无显著差异(P>0.05)。通过分析发现,男性患内膜增厚、斑块形成、颈动脉块狭窄或闭塞、大脑中动脉狭窄或闭塞的概率高于女性(P<0.05);而两性患颅内椎基底动脉狭窄或闭塞的概率相当(P>0.05)。斑块形成组和斑块未形成组在年龄、高血压、糖尿病、冠心病、明显超重或肥胖上存在明显差异(P<0.05),而两组在高血脂方面的差异无统计学意义(P>0.05);临床经多因素Logistic回归分析结果显示,高血压、冠心病、明显超重或肥胖、≥60岁为脑卒中高危患者形成颈动脉斑块的独立影响因素(P<0.05)。结论联合应用颈动脉与脑动脉可实现对脑卒中患者颅内血流的快速准确评估,为脑卒中高风险人群的早期筛查奠定基础。在临床实践中,针对高血压、冠状动脉疾病、显著超重或肥胖以及年龄超过60岁的人群,有必要实施早期干预。Objective To explore clinical application value of integrated carotid cerebral artery ultrasound in high-risk populations with stroke.Methods The paper chose 256 high-risk stroke patients in outpatient and physical examination department of the hospital from January 2021 to April 2023 as research subjects,treated with integrated carotid cerebral artery ultrasound examination,and analyzed age,gender and carotid plaque formation based on univariate and multivariate logistic regression analyses.Results Study found,patients with cerebrovascular disease aged 60 and above were more prone to endometrial thickening,plaque formation,carotid artery occlusion or stenosis and intracranial vertebrobasilar artery stenosis or occlusion than patients aged 40~60(P<0.05).Cerebral artery stenosis and obstruction between different age groups showed P>0.05.Analysis found,male patients with intimal thickening,plaque formation,carotid artery block stenosis or occlusion,and middle cerebral artery stenosis or occlusion were higher than female(P<0.05).Gender in intracranial vertebrobasilar artery stenosis or occlusion showed(P>0.05).There was significant difference in age,hypertension,diabetes,coronary heart disease,overweight or obesity between plaque forming group and plaque non forming group(P<0.05),while hyperlipidemia showed(P>0.05).Clinical multivariate logistic regression analysis showed,hypertension,coronary heart disease,overweight or obesity,and age≥60 were independent influencing factors(P<0.05).Conclusion Combined application of carotid and cerebral arteries can achieve fast and accurate assessment of intracranial blood flow of stroke patients,lay foundation for early screening of high-risk stroke populations.During clinical practice,it is necessary to carry out early intervention for individuals with hypertension,coronary heart disease,overweight or obesity and those aged 60 and above.

关 键 词：颈脑动脉一体化超声 脑卒中 高危人群 

分 类 号：R54[医药卫生—心血管疾病]