缺血性脑卒中患者CAS斑块超声、CT血管造影及临床相关危险因素分析

Ultrasonography and CT Angiography for Carotid Atherosclerosis Plaque and Clinical Related Risk Factors Analysis in Patients with Ischemic Cerebral Stroke

目的探讨缺血性脑卒中（ICS）患者颈动脉粥样硬化（CAS）斑块的超声检查与CT血管造影（CTA）的影像表现,分析ICS患者CAS斑块临床相关危险因素。方法回顾性分析2013年6月至2015年6月575例ICS患者的颈动脉超声检查以及CTA资料,对两种检查方法的结果进行对比。分析ICS CAS斑块相关危险因素,对相关危险因素进行单因素和多因素分析。结果颈动脉超声检查结果与CTA结果几乎完全一致,Kappa值为0.867。单因素分析显示糖尿病、高血脂、年龄均为ICS患者CAS斑块发生的危险因素（χ^2=46.000,15.018,52.613,均P〈0.05）。多因素Logistic回归分析显示,高血脂是ICS患者CAS的独立危险因素。结论颈动脉超声检查准确性高,对CAS斑块筛查与CTA结果几乎完全一致。高血脂是CAS斑块形成的主要危险因素,在日常临床工作中应对高血脂患者进行降血脂治疗以及饮食控制,进而避免CAS发生。

Aim To investigate the image representation of ultrasonography and CT angiography（ CTA） for carotid atherosclerosis（ CAS） plaque in patients with ischemic cerebral stroke（ ICS）.Methods Carotid ultrasonography and CTA data were retrospectively analyzed in 575 patients with ICS from June 2013 to June 2015.The results of the two inspection methods were compared.ICS CAS plaque related risk factors were analyzed.Single factor and multi-factor analysis were applied for the related risk factors.Results The results of carotid ultrasonography and CTA were almost identical,and Kappa value was 0.867.Single factor analysis showed that diabetes,hyperlipidemia and age were the risk factors of CAS plaque in patients with ICS（ χ^2=46.000,15.018,52.613,all P〈0.05）.Multi-factor Logistic regression analysis showed that hyperlipidemia was an independent risk factor of CAS in patients with ICS.Conclusions Carotid ultrasonography is of high accuracy,and it is almost identical with CTA results to the CAS plaque screening.Hyperlipidemia is a major risk factor for the formation of CAS plaque.In the daily clinical work,patients with hyperlipidemia should be treated with lipid-lowering therapy and diet control,and then to avoid the occurrence of CAS.