颈动脉斑块超微血管成像对脑梗死的预测价值

Predictive value of hypermicrovascular imaging of carotid plaque for cerebral infarction

目的探讨颈动脉斑块超微血流显像(SMI)对两年内脑梗死的预测价值。方法选择2016年8月至2018年8月500例颈动脉粥样硬化伴斑块形成的患者作为研究对象,记录年龄、性别、血脂、Crouse斑块积分、颈动脉斑块SMI评分等相关临床资料。根据2年内是否发生脑梗死分为梗死组和非梗死组。比较两组的一般临床资料及Crouse斑块积分、颈动脉斑块SMI评分,并使用ROC曲线预测诊断指标。结果与非梗死组比较,梗死组患者入院时体质指数(BMI)、血清三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-L)、颈动脉Crouse斑块积分、颈动脉斑块SMI评分均较高,差异有统计学意义(P<0.05)。对其进行多因素Logistics回归分析,发现入院时BMI(OR=0.231,95%CI为0.069~0.769)、血清TC(OR=1.090,95%CI为1.003~1.269)、LDL-L(OR=1.754,95%CI为1.242~2.478)、颈动脉Crouse斑块积分(OR=1.050,95%CI为1.007~1.095)、颈动脉斑块SMI评分(OR=0.089,95%CI为0.031~0.256)是脑梗死患者的独立危险因素,差异有统计学意义(P<0.05)。入院时颈动脉斑块SMI评分对脑梗死预测的诊断界值为1.56分,灵敏度为82.23%,特异度为88.40%。结论脑梗死患者入院时颈动脉斑SMI评分对患者脑梗死具有一定的预测价值。

Objective To investigate the predictive value of carotid plaque Supermicrovasscular imaging(SMI) for cerebral infarction.Methods From August 2016 to August 2018,500 patients with carotid atherosclerosis and plaque formation were selected.The clinical data of age,sex,blood lipid,Crouse plaque score and carotid plaque SMI scores were recorded.According to whether or not cerebral infarction occurred within 2 years,the patients were divided into infarction group and non-infarction group.The general clinical data,Crouse plaque score and carotid plaque SMI score were compared between the two groups.The ROC curve was used to predict the diagnostic index.Results Compared with non-infarct group,the BMI,serum triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-L) and Crouse plaque score of carotid artery and SMI score of carotid artery plaque were higher in infarction group at admission(P<0.05).Multivariate logistic regression analysis revealed BMI at admission(OR=0.231,95% CI 0.069-0.769),serum TC(OR=1.090,95%CI 1.003-1.269),LDL-L(OR=1.754,95%CI 1.242-2.478),carotid Crouse plaque score(OR=1.050,95% CI 1.007-1.095),carotid plaque SMI score(OR=0.089,95%CI 0.031-0.256) were independent risk factors for cerebral infarction(P<0.05).At admission,the diagnostic threshold of carotid plaque SMI score for cerebral infarction was 1.56,the sensitivity was 82.23%,and the specificity was 88.40%.Conclusions The SMI score of carotid plaque at admission of patients with cerebral infarction has certain predictive value for cerebral infarction.