急性缺血性脑卒中患者颈动脉斑块的超声特征分析  

Ultrasound characteristics of carotid artery plaques and risk factors for unstable plaques in patients with acute ischemic stroke

作　　者：刘旭 Liu Xu(Department of Ultrasound Medicine,Miyun Campus,Miyun District Traditional Chinese Medicine Hospital in Beijing,Beijing 101500,China)

机构地区：[1]北京市密云区中医医院超声医学科,101500

出　　处：《实用医学影像杂志》2025年第2期114-119,共6页Journal of Practical Medical Imaging

摘　　要：目的探讨急性缺血性脑卒中患者颈动脉斑块的超声特征,对不稳定斑块的危险因素进行分析。方法以北京市密云区中医医院为地点,于2021年1月至2023年1月选100例急性缺血性脑卒中患者为观察组,非卒中患者100例为对照组。2组均行彩色多普勒超声检查,对其颈内动脉、颈外动脉、双侧颈总动脉范围内的斑块形成情况、数量情况、稳定情况以及颈动脉狭窄情况进行比较。以斑块稳定情况为依据对观察组进行再次分组(稳定亚组54例、不稳定亚组46例),对2组一般资料进行单因素分析,根据单因素差异结果对斑块不稳定的危险因素进行Logistic回归分析。结果观察组斑块检出率(71.0%)高于对照组(27.0%),差异有统计学意义(P<0.001)。同时观察组中斑块多发比例、不稳定斑块比例高于对照组,差异有统计学意义(P<0.001);观察组与对照组的颈动脉狭窄情况分布比较无统计学意义(P>0.05)。同时颈动脉狭窄亚组的不稳定斑块比例高于非颈动脉狭窄亚组,差异有统计学意义(P<0.05);对观察组以斑块稳定性分组后,稳定亚组与不稳定亚组的性别、高血压比例、心房颤动比例、饮酒比例比较无统计学意义(P>0.05)。不稳定亚组的年龄、糖尿病比例、抽烟比例高于稳定亚组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示年龄、糖尿病、抽烟均是导致急性缺血性脑卒中患者斑块不稳定的危险因素(P<0.05)。结论急性缺血性脑卒中患者的颈动脉斑块数量相较于非卒中患者明显更多且不稳定斑块数量更多,颈动脉狭窄情况更加严重;年龄、糖尿病以及抽烟习惯是导致急性缺血性脑卒中患者斑块不稳定的危险因素。Objective To explore the ultrasound characteristics of carotid artery plaques in patients with acute ischemic stroke and analyze the risk factors for unstable plaques.Methods A total of 100 patients with acute ischemic stroke were selected as the observation group and 100 non-stroke patients as the control group from January 2021 to January 2023 at Miyun District Traditional Chinese Medicine Hospital in Beijing.Both groups underwent color Doppler ultrasound examination to compare the plaque formation,quantity,stability,and carotid artery stenosis within the internal carotid artery,external carotid artery,and bilateral common carotid artery ranges.Based on the stability of plaques,the observation group was re-grouped(stable subgroup was 54,unstable subgroup was 46).Univariate analysis was performed on the general data of the two groups,and Logistic regression analysis was performed on the risk factors for plaque instability based on the difference in single-factor results.Results The plaque detection rate in the observation group(71.0%)was higher than that in the control group(27.0%),and the difference was statistically significant(P<0.001).The proportion of multiple plaques and unstable plaques in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.001).There was no statistically significant difference in the distribution of carotid artery stenosis between the observation group and the control group(P>0.05).The proportion of unstable plaques in the carotid artery stenosis subgroup was higher than that in the non-carotid artery stenosis subgroup,and the difference was statistically significant(P<0.05).After grouping the observation group by plaque stability,there was no statistically significant difference in gender,hypertension ratio,atrial fibrillation ratio,and alcohol consumption ratio between the stable and unstable subgroups(P>0.05).The age,diabetes ratio,and smoking ratio of unstable subgroups were higher than those of stable subgroups(P<0.05)

关 键 词：缺血性卒中 超声 斑块 不稳定 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]