颈动脉超声对缺血性脑卒中的诊断及预后评估的价值

The value of carotid arteryultrasound for the diagnosis and prognosis evaluation of cerebral ischemic stroke

目的探讨颈动脉超声对缺血性脑卒中的诊断及预后评估的价值。方法选取来我院就诊的资料完整的缺血性脑卒中患者112例(卒中组),并选取同期健康体检者96例为对照组,行颈动脉超声检查,获取IMT、PSV、RI,并观察是否有颈动脉斑块及斑块性质。分析2组间各超声参数的差异,并行NIHSS、mRS评分及观察血管事件发生率,与超声参数进行比较。结果卒中组IMT、RI均较对照组明显增高(t=9.71、4.69,P=0.00),PSV较对照组减低(t=6.94,P=0.00)。卒中组斑块及易损斑块发生率较对照组明显增高(χ2=36.37、5.93,P=0.00、0.01)。随着NIHSS评分、mRS评分及血管事件发生率的增加,颈动脉的IMT、PSV、RI及斑块发生率差异均无统计学意义(P>0.05)。但易损斑块发生率在不同NIHSS评分、mRS等级及血管事件发生率间差异有统计学意义(P<0.05)。结论 IMT厚度、PSV、RI、是否存在颈动脉斑块及易损斑块对缺血性脑卒中有一定诊断价值,其中是否存在易损斑块与脑卒中患者病情程度及预后相关。

Objective To investigate the value of carotid artery ultrasound for the diagnosis and prognosis evaluation of cerebral ischemic stroke.Methods We selected 112 cerebral ischemic stroke patients with full information as stroke group and 96 physical examination cases as control group.Carotid ultrasound examination was operated and IMT,PSV,RI and nature of plaque were observed.Then the ultrasonic parameters differences between the two groups were analyzed.NIHSS,mRS scores and vascular events in patients with stroke were assessed and compared to ultrasound parameters.Results IMT,RI in stroke group were significantly increased compared with control group（t=9.71,4.69,P=0.00）and PSV was reduced（t=6.94,P=0.00）.The patients with stroke had higher incidence of plaques and vulnerable plaques（χ^2=36.37,5.93,P=0.00,0.01）.With the increase of NIHSS,mRS score and vascular events,the IMT,PSV,RI and plaque incidence had no differences（P〉0.05）,but the incidences of vulnerable plaques were significant different（P〈0.05）.Conclusion The IMT,PSV,RI,presence of carotid plaques and vulnerable plaques have certain diagnostic value on ischemic stroke.And the presence of vulnerable plaques is associated with stroke patient＇s degree and prognosis.