超声分析缺血性心肌病并发脑卒中患者相关危险因素

Analysis of risk factors of ischemic stroke in patients with ischemia cardiomyopathy with ultrasonography

目的通过分析缺血性心肌病(ICM)并发缺血性脑卒中(IS)患者的超声心动图和颈动脉超声异常表现,探讨其发病危险因素。方法应用二维彩色多普勒超声(2D-CDUS)对168例ICM患者和60名健康志愿者行超声心动图和颅外段颈动脉超声检测,观察心脏大小、心肌运动、心腔内有无血栓、主动脉瓣是否钙化、颈动脉内-中膜厚度、有无粥样斑块。检查后随访观察1年。以首次心脏和颈动脉的异常超声表现为依据,分析患者发病相关危险因素。结果随访观察1年,168例患者中有45例发生IS。多因素Logistic回归分析显示,主动脉瓣钙化、左心室心肌节段性运动异常、颈动脉粥样斑块是ICM伴发IS的独立危险因素。结论ICM患者并发IS受多种因素影响。经胸超声心动图和颈动脉超声检测是检测发病危险因素的有效方法,并为判断病程进展提供重要依据。

Objective To assess risk factors of ischemia stroke in patients with ischemia cardiomyopathy （ICM） by means of analyzing the echoeardiography and ultrasound findings of carotid artery. Methods Echocardiography and carotid ultrasonography were performed on 16.8 patients with ICM and 60 normal subjects （control group） with two-dimensional color Doppler ultrasound （2D-CDUS） to observe the heart size, myocardial motion, and to find out whether there were ventricular thrombus, aortic valve calcification and carotid artery plaque carotid intima-media thickness （IMT）. Follow-up was made within 1 year after examination. The related risk factors that caused the disease were analyzed based on the first abnormal ultrasound performance of heart and carotid. Results In 168 patients with ICM, ischemia strokes occurred in 45 in the following year. Multivariable analysis showed that aortic valve calcification, left ventricular segmental motion abnormalities and atherosclerotic plaque in the carotid were independent predictive factors of ischemia stroke. Conclusion Occurrence of ICM combined with ischemia stroke is affected by many factors. Echocardiography and carotid ultrasonography provide a unique tool for detect of high risk factors and also an important basis for judging the development of disease.