颈部血管超声对短暂性脑缺血发作患者颅外段颈动脉狭窄的诊断价值

Diagnostic value exploration of cervical vascular ultrasonic inspection for carotial stenosis in patients with transient ischemic attack

目的研究颈部血管超声对短暂性脑缺血发作(transient ischemic attack,TIA)的诊断价值。方法选取本院2015年11月至2016年11月门诊就诊和住院的TIA患者201例为研究对象,根据是否合并脑梗死将患者分为TIA 1组(单纯TIA发作)和TIA 2组(TIA发作+脑梗死病史);选取本院同期无脑梗死或TIA患者共100例纳入对照组。采用颈部血管超声检查三组患者颈动脉狭窄程度和斑块性质。结果三组患者颈动脉狭窄程度的分布具有显著差异(P<0.05),且TIA 2组患者颈动脉狭窄程度较TIA 1组和对照组更严重,对照组患者颈动脉狭窄程度最轻(P<0.05)。TIA 1组与TIA 2组患者颈动脉狭窄检出率和斑块检出率比较均无显著差异(P>0.05),但两组患者颈动脉狭窄检出率和斑块检出率均显著高于对照组(P<0.05)。TIA 1组与TIA 2组患者不同性质斑块分布比较无显著差异(P>0.05),TIA 2组与对照组比较亦无显著差异(P>0.05),TIA 1组与对照组比较具有显著差异(P<0.05)。结论颈部血管超声可较好地显示TIA患者颈动脉狭窄程度和斑块情况。单纯TIA患者的颈部血管病变程度与脑梗死患者相近,应及早对其进行干预治疗。

Objective To explore the diagnostic value of cervical vascular ultrasonic inspection for the patients with transient ischemic attack （TIA）. Method 201 patients with TIA in our hospital from November 2015 to November 2016 were divided into TIA 1 group （simle TIA history） and TIA 2 group （TIA ＋ cerebral infarction history） according to whether combined with cerebral infarction. Selected 100 patients without cerebral infarction or TIA in our hospital into control group at the same time. Patients in three groups were all applied with cervical vascular ultrasonic inspection to test the degree of carotid stenosis and the nature of the plaque. Result There were significant diffrences at distribution levels of carotial stenosis among the three groups （P 〈 0.05）. The carotial stenosis in TIA 2 group was more serious than TIA 1 group and control group, and the carotial stenosis in control group was the lightest （P 〈 0.05）. The detection rate of carotial stenosis and the plaque detection rate in TIA 1 group and TIA 2 group showed no significant differences （P 〉0.05）, but both were significantly higher than those in control group （P 〈 0.05）. There was no significant difference in plaque distribution between TIA 1 group and TIA 2 group （P 〉 0.05）, there was no significant difference between TIA 2 group and control group （P 〉 0.05）, there was significant difference between TIA 1 group and control group （P 〈 0.05）. Conclusion Cervical vascular ultrasonic inspection has the advantage of showing TIA patients with carotial stenosis and plaques. Simple TIA patients have the similar degree of cervical vascular lesions to the patients with cerebral infarction, and it should be taken early intervention therapy for patients with TIA.