摘要
目的探讨三维超声评价颈动脉斑块易损性与脑梗死的关系。方法2019年1月至2019年6月嘉兴市第二医院超声发现颈动脉斑块患者96例,根据头颅MRI和CT检查结果,分为脑梗死组56例,非脑梗死组40例,进一步行三维超声检查,应用血管斑块定量分析(VPQ)软件获取颈动脉斑块的灰阶中位数(GSM)、斑块厚度(PT)、斑块体积(PV)和面积狭窄率,观察脑梗死组患者1年内复发情况,比较脑梗死组1年内复发患者(复发亚组)和未复发亚组患者的GSM、PT、PV、面积狭窄率。结果脑梗死组患者LDL-C水平(3.53±0.62)mmol/L、PV值(171.62±31.8)mm~3均高于非脑梗死组[(3.16±0.49)mmol/L、(159.65±26.48)mm~3],GSM值(41.27±9.25)低于非脑梗死组(50.53±10.60),差异均有统计学意义(均P<0.05);13例复发亚组患者GSM值(36.40±8.10)低于未复发亚组(42.76±9.72),差异有统计学意义(P<0.05)。低GSM亚组患者脑梗死复发率(35.71%)明显高于高GSM亚组(10.71%),差异有统计学意义(P<0.05)。LDL-C、PV与脑梗死无显著相关性(P>0.05),GSM值是脑梗死的主要危险因素(P<0.05)。ROC曲线分析显示,GSM诊断脑梗死的AUC为0.809。结论三维超声GSM有助于评估颈动脉斑块的易损性与脑梗死风险。
Objective To investigate the value of three-dimensional ultrasound detecting carotid plaque vulnerability in the diagnosis and prognosis evaluation of cerebral infarction(CI).Methods 96 patients with carotid plaques detected by ultrasound were recruited in the Second Hospital of Jiaxing from January 2019 to June 2019.Of them,56 patients were assigned to CI group and 40 cases to non-CI group based on the results of cranial MRI and CT.All patients underwent three-dimensional ultrasound examination.The gray-scale median(GSM),plaque thickness(PT),plaque volume(PV)and area stenosis rate(ASR)of carotid plaques were determined using vascular plaque quantitative analysis software.The recurrence rate of CI in CI patients within 1 year was observed.GSM,PT,PV and ASR were compared between patients with and without recurrent CI.Results LDL-C and PV were significantly higher,GSM was significantly lower in patients with CI than in patients without CI(all P<0.05).CI recurred in 13 cases in patient with CI during one year follow-up.GSM was significantly lower in patients with recurrent CI(36.40±8.10)than in patients without recurrent CI(42.76±9.72)(P<0.05).The recurrence rate was significantly higher in patients with low GSM(35.71%)than in patients with high GSM(10.71%)(P<0.05).There was no significant difference in PV,PT and ASR between patients with and without recurrent CI.GSM was the main risk factor for CI(P<0.05).ROC curve analysis showed that the AUC of GSM diagnosing CI was 0.809.Conclusion Three-dimensional ultrasound parameter GSM maybe helpful for evaluating carotid plaque vulnerability and CI risk.
作者
朱长玉
张珍东
张玮
郭微群
周华玲
过姿芳
马旦杰
沈和平
ZHU Changyu;ZHANG Zhendong;ZHANG Wei;GUO Weiqun;ZHOU Hualing;GUO Zifang;MA Danjie;SHEN Heping(Department of Ultrasonic,the Second Hospital of Jiaxing,Jiaxing 314500,China)
出处
《心电与循环》
2021年第1期40-44,共5页
Journal of Electrocardiology and Circulation
基金
嘉兴市科学技术局项目(2019AD32133)。
关键词
三维超声
脑梗死
颈动脉斑块
灰阶中位数
预后
Three-dimensional ultrasound
Cerebral infarction
Carotid plaque
Gray-scale median
Prognosis
