摘要
目的采用超声造影检测分析颈动脉粥样硬化性易损斑块内新生血管(IPN)与缺血性脑血管病症状发生的相关性。方法回顾性连续纳入2019年1月至2021年12月首都医科大学宣武医院神经内外科经常规超声检查发现颈动脉斑块并接受超声造影检查的缺血性脑血管病患者122例。根据是否出现缺血性脑血管病症状将患者分为无症状组和症状组。分析两组患者颈动脉粥样硬化责任斑块超声造影特征(斑块厚度、斑块长度及回声特征)的差异性,以及IPN、溃疡性斑块、动脉狭窄程度(狭窄率≥70%为重度狭窄)等因素与缺血性脑血管病症状发生的相关性。结果122例患者中,无症状组47例,症状组75例。症状组MRI缺血性病灶患者比例、血管重度狭窄比例、IPN患者比例均明显高于无症状组[分别为80.0%(60/75)比46.8%(22/47),χ^(2)=14.44,P<0.01;84.0%(63/75)比51.1%(24/47),χ^(2)=15.32,P<0.01;78.7%(59/75)比34.0%(16/47),χ^(2)=8.74,P<0.01],症状组斑块长度明显长于无症状组[26.00(20.30,30.01)mm比20.20(17.28,25.75)mm,Z=-3.20,P=0.01]。多因素Logistic回归分析结果显示,IPN、血管重度狭窄是缺血性脑血管病症状发生的独立预测因素(OR=6.77,95%CI:2.24~20.46,P<0.01;OR=9.92,95%CI:2.37~41.64,P<0.01),溃疡性斑块并非缺血性脑血管病症状发生的危险因素(OR=0.70,95%CI:0.24~2.00,P=0.50)。结论IPN是缺血性脑血管病症状发生的独立危险因素。
Objective To analyze the correlation between intra-plaque neovascularization of carotid atherosclerotic plaques by using contrast-enhanced ultrasound(CEUS)and symptomatic ischemic cerebrovascular disease.Methods From January 2019 to December 2021,122 patients with carotid atherosclerotic plaques detected by carotid duplex ultrasonography(CDU)and CEUS in the Department of Neurology or Neurosurgery,Xuanwu Hospital of Capital Medical University were retrospectively enrolled and divided into non-symptomatic group and symptomatic group according to clinical symptoms.The CEUS examination was performed in both groups to analyze the differences in the characteristics of carotid atherosclerotic plaques(plaque thickness,plaque length and echo characteristics),as well as the correlation between factors such as intra-plague neovascularization,ulceration,degree of artery stenosis(severe stenosis rate≥70%)and the occurrence of symptoms of ischemic cerebrovascular disease.Results A total of 122 patients were included in this study and divided into asymptomatic group(47 cases)and symptomatic group(122 cases).The rate of cases with MRI cerebral infarction,the incidence of severe stenosis(≥70%)and the incidence of intra-plaque neovascularization in symptomatic group was significantly higher than that of the cases in non-symptomatic group(80.0%[60/75]vs.46.8%[22/47],χ^(2)=14.44,P<0.01;84.0%[63/75]vs.51.1%[24/47],χ^(2)=15.32,P<0.01;78.7%[59/75]vs.34.0%[16/47],χ^(2)=8.74,P<0.01).The plaque length in symptomatic group was significantly longer than that of asymptomatic group(26.00[20.30,30.01]mm vs.20.20[17.28,25.75]mm,Z=-3.20,P=0.01).Multivariate Logistic regression analysis showed that intra-plaque neovascularization and severe artery stenosis were independent predictors of symptomatic ischemic cerebral ischemia(OR,6.77,95%CI 2.24-20.46,P<0.01;OR,9.92,95%CI 2.37-41.64,P<0.01),while ulcerated plaque was not(OR,0.70,95%CI 0.24-2.00,P=0.50).Conclusion The intra-plaque neovascularization is a risk factor for symptomatic ischemic c
作者
李景植
华扬
刘然
杨洁
Li Jingzhi;Hua Yang;Liu Ran;Yang Jie(Department of Ultrasound,Mentougou Maternal and Child Healthcare Hospital,Beijing 102300,China)
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2023年第2期90-95,共6页
Chinese Journal of Cerebrovascular Diseases
基金
首都医科大学宣武医院院级课题(XWJL-2018039)。
关键词
颈动脉斑块
斑块内新生血管
溃疡斑块
超声造影
缺血性脑血管病
Carotid atherosclerotic plaques
Intra-plaque neovascularization
Ulcerated plaque
Contrast-enhanced ultrasonography
Ischemic cerebrovascular disease
