摘要
目的探讨缺血性脑卒中患者颈动脉粥样斑块发生与踝肱指数的相关性。方法对236例缺血性脑卒中患者(观察组)和260名健康人(对照组)应用彩色多普勒超声检测颈部血管内中膜厚度及斑块形成情况,使用多普勒超声仪测量踝肱指数,并分析踝肱指数与颈动脉粥样硬化的程度和稳定性的相关性。结果 236例观察组患者中,检出颈动脉粥样硬化斑块183例(77.5%),对照组为60例(23.1%),缺血性脑卒中颈动脉粥样硬化斑块发生率明显高于对照组(P<0.01)。观察组22例踝肱指数异常,发生率为9.3%;对照组有6例踝肱指数异常,发生率为2.3%,2组比较差异有统计学意义(P<0.01)。缺血性脑卒中患者颈动脉内膜增厚组踝肱指数明显低于正常组,颈动脉内膜斑块形成组患者的踝肱指数明显低于增厚组(P<0.05),颈动脉内膜不稳定斑块组踝肱指数明显低于稳定斑块组(P<0.05)。Logistic回归分析显示颈动脉粥样硬化斑块、踝肱指数与缺血性脑卒中明显相关(OR分别为1.118、0.054,P均<0.05)。结论颈动脉粥样硬化与缺血性脑卒中有关,踝肱指数可作为预测缺血性脑卒中发生的指标之一。
Objective To evaluate the relationship between carotid atherosclerosis and the ankle-brachial index in isehemic stroke patients. Methods Color Doppler ultrasound examinations were performed in 236 ischemic stroke patients （study group） and 260 healthy volunteers （control group） to examine the carotid intima-media thickness and carotid atherosclerotic plaque formation. The ankle-brachial index （ABI） was measured using Doppler ultrasound. The correlation between the ABI and the extent and stability of carotid atheroselerotic plaques was assessed. Results Among the 236 patients in the study group, 183 exhibited carotid atheroselerotic plaques, with an incidence rate of 77. 5% , while 60 of the 260 volunteers in the control group exhibited carotid atherosclerotic plaques, resulting in an incidence rate of 23.1%. The incidence rate of atherosclerotic plaques was significantly higher in ischemic stroke patients compared with healthy volunteers （P 〈 0.01 ）. Among the ischemic stroke patients, 22 （9. 3% ） had an abnormal ABI, while six subjects in the control group （2. 3% ） had an ABI abnormality. The difference between the two groups was statistically significant （P 〈 0. 01 ）. The ABI of the patients with a thickened carotid intima in the study group was remarkably lower than that of the normal control group, and the ABI of patients with plaques in the carotid intima was significant- ly lower than that of the patients with a thickened carotid intima （P 〈 0. 05）. Furthermore, the ABI of patients with unstable plaques in the carotid intima was markedly lower than that of patients with stable plaques （P 〈 0.05）. Carotid atherosclerotic plaques and the ABI were correlated with ischemic stroke （OR = 1. 118 and 0. 054, respectively, P 〈 0.05 ）. Conclusions Carotid artery arteriosclerosis and, in particular, unstable plaques are closely associated with ischemic stroke. The ABI can be used as an indicator of risk for an isehemic stroke.
出处
《新医学》
2015年第7期475-478,共4页
Journal of New Medicine
关键词
缺血性脑卒中
颈动脉粥样硬化
踝肱指数
Ischemic stroke
Carotid artery arteriosclerosis
Ankle-brachial index
