摘要
目的探讨超声检测缺血性脑卒中／短暂性脑缺血发作（TIA）患者的颈动脉粥样硬化与冠状动脉粥样硬化的相关性。方法选择自2014年8月至2015年8月佛山市第一人民医院神经内科收治并确诊为首发缺血性脑卒中（改良TOAST分型为AT型1及TIA患者共165例为研究对象，其中以冠状动脉CT血管造影（CTA）检查发现冠状动脉病变者80例为病例组，无冠状动脉病变者85例为对照组，结合动脉粥样硬化危险因素的检查，探讨超声检测在缺血性脑卒中／TIA合并冠状动脉病变患者筛查中的作用。结果结合血浆低密度脂蛋白（LDL）和高密度脂蛋白（HDL）水平，以超声检测到易损斑块判断冠状动脉粥样硬化，其敏感度（66．25％）、特异度（76．47％）、阳性预测值（72．60％）及阴性预测值（70．65％）均较高，判别正确率为71．5％（Wilks’λ=0．856，x2=24．881，p=0．000）。结论结合血脂检查，超声检测到易损斑块可作为评估缺血性脑卒中／TIA患者合并冠状动脉粥样硬化病变的有效指标。
Objective To investigate the association between carotid atherosclerosis and coronary atherosclerosis in ischemic stroke/transient ischemic attack （TIA） patients using color Doppler ultrasound. Methods A total of 165 patients with first episode of atherothrombosis （AT）/TIA patients were enrolled from August 2014 to August 2015 in our hospital; 80 patients with coronary artery diseases detected by coronary CT angiography were used as disease group, and 85 without coronary artery disease were as control group. Combining with the examination of the risk factors of atherosclerosis, the value of colored Doppler ultrasound in screening coronary atherosclerosis in ischemic stroke/TIA patients was evaluated. Results Combined with plasma low density lipoprotein and high-density lipoprotein levels, the vulnerable plaques were detected by colored Doppler ultrasound, enjoying detection of coronary atherosclerosis sensitivity of 66.25%, specificity of 76.47%, positive predictive value of 72.60% and negative predictive value of 70.65%, and accuracy of 71.5% （ Wilkes＇ Lambda=0.856, Xz=-24.881, P=0.000）. Conclusion Combining with blood lipid level, vulnerable plaque can be the effective indicator for coronary atherosclerosis in patients with ischemic stroke/TIA.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2016年第4期375-378,共4页
Chinese Journal of Neuromedicine
关键词
动脉粥样硬化
缺血性脑卒中
颈动脉超声
Coronary atherosclerosis
Ischemic stroke
Color Doppler ultrasotmd
