社区缺血性脑卒中高危人群大脑中动脉经颅彩色多普勒超声筛查结果分析  

Analysis of Transcranial Color Doppler Ultrasound Screening Results of Middle Cerebral Artery in High-Risk Population of Ischemic Stroke in Community

作　　者：叶红蕾 YE Honglei(Department of Special Diagnosis,Xinjiekou Community Hospital,Nanjing City,Nanjing,Jiangsu 210016,China)

机构地区：[1]南京市新街口社区医院特诊科,江苏南京210016

出　　处：《中国医药指南》2025年第10期26-28,共3页Guide of China Medicine

摘　　要：目的探讨经颅彩色多普勒超声(TCCD)在社区缺血性脑卒中高危人群大脑中动脉筛查中的应用。方法于2024年2月至2025年1月对南京市新街口社区医院55岁及以上常住就诊人群,现场询问、调查且依据高血压、高血脂、高血糖、高体重等筛查缺血性脑卒中高危人员66例,均行TCCD大脑中动脉检查。结果CTA检查大脑中动脉狭窄程度结果为:轻度狭窄27例,中度狭窄23例,重度狭窄13例,闭塞3例。在评估缺血性脑血管病患者大脑中动脉狭窄程度时,TCCD与CT血管造影(CTA)的诊断一致性较高,诊断符合率为96.97%,Kappa值为0.924。重度狭窄患者收缩期血流速度(Vs)、平均血流速度(Vm)高于中度及轻度狭窄患者,搏动指数(PI)低于中度及轻度狭窄患者;中度狭窄患者Vs、Vm高于轻度狭窄患者,PI低于轻度狭窄患者(均P<0.05)。结论TCCD检查大脑中动脉与CTA检查的一致性较高,为社区脑卒中患者的筛查提供了可靠的影像学依据,有利于缺血性脑病患者早诊断、早治疗。Objective To explore the application of transcranial color Doppler ultrasonography(TCCD)in the screening of middle cerebral artery in high-risk groups of ischemic stroke in the community.Methods From February 2024 to January 2025,66 patients aged 55 and above in Nanjing Xinjiekou Community Hospital were interviewed,investigated and screened on the basis of hypertension,hyperlipidemia,hyperglycemia,and high body weight.All 66 patients at high risk of ischemic stroke were examined by TCCD.Results Among the 66 patients with ischemic cerebrovascular disease,the results of CTA for the degree of stenosis of the middle cerebral artery,there were 27 cases with mild stenosis,23 cases with moderate stenosis,13 cases with severe stenosis,and 3 cases with occlusion,indicating that these patients were at high risk.The Kappa value of the consistency between the degree of middle cerebral artery stenosis diagnosed by TCCD and CT angiography(CTA)in patients with ischemic cerebrovascular disease was 0.924(95%CI 0.790-1.059),and the diagnostic coincidence rate was 96.97%.Systolic bloodflow velocity(Vs)and mean bloodflow velocity(Vm)in patients with severe stenosis were higher than those in patients with moderate and mild stenosis,and pulsatile index(PI)was lower than those in patients with moderate and mild stenosis.Vs and Vm were higher in patients with moderate stenosis than in patients with mild stenosis,and PI was lower than in patients with mild stenosis(P<0.05).Conclusions The consistency between TCCD examination of middle cerebral artery and CTA examination is high,which provides a reliable imaging basis for the screening of stroke patients in the community,and is conducive to the early diagnosis and early treatment of ischemic encephalopathy patients.

关 键 词：缺血性脑卒中 经颅彩色多普勒超声 大脑中动脉 CT血管造影 脑卒中高危因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]