彩色多普勒超声诊断脑卒中患者颈动脉斑块的临床价值探析

Clinical value of color Doppler ultrasound in diagnosis of carotid plaque in patients with stroke

目的:探讨彩色多普勒超声诊断方法在脑卒中临床诊断中的应用价值,根据颈动脉斑块检出结果进行评价。方法:选取2018年3月—2019年2月期间内于我院接受诊疗的65例脑卒中患者和同期接受检查的65例健康体检者作为研究对象,各自作为观察组和对照组。结果:与对照组受检者相比,观察组脑卒中患者颈动脉斑块检出率(79.46%>44.62%,χ^2=15.730)、颈动脉内膜增厚检出率(38.46%>16.92%,χ^2=7.529)、颈动脉收缩期的最大血流速度(PSV)水平[(70.94±2.91)cm/s>(66.05±1.85)cm/s,t=6.157]以及颈动脉阻力指数(RI)水平[(0.89±0.08)>(0.59±0.05),t=5.367]相对更高(P<0.05),舒张期最小血流速度(EDV)水平[(17.02±1.63)cm/s>(24.05±1.05)cm/s,t=5.367]相对更低(P<0.05)。在65例脑卒中患者的颈动脉斑块超声检查中,小面积梗死患者与大面积梗死患者的扁平斑、硬化斑和混合斑检出率高于腔隙性梗死患者。在小面积梗死患者中,存在扁平斑、硬化斑的患者比例更高。在大面积梗死患者中,存在混合斑的患者比例更高。结论:在脑卒中患者接受彩色多普勒超声诊断的过程中,能够准确检出颈动脉斑块,根据斑块的性质和特点,鉴别脑血管病变类型。

Objective To explore the value of color Doppler ultrasound in the clinical diagnosis of stroke,and to evaluate the results of carotid plaque detection.Methods 65 stroke patients and 65 health check-ups who were diagnosed and treated in our hospital from March 2018 to February 2019 were selected as the research objects,and they were the observation group and the control group respectively.Results Compared with the control group,the detection rate of carotid artery plaque(79.46%>44.62%,χ^2=15.730),carotid intimal thickening(38.46%>16.92%,χ^2=7.529)and the maximum blood flow velocity(PSV)level[(70.94+2.91)cm/s>(66.05+1.85)cm/s,t=6.15]cm/s in the observation group were higher than those in the control group.7]and carotid resistance index(RI)[(0.89+0.08)>(0.59+0.05),t=5.367]were relatively higher(P<0.05),and the minimum diastolic flow velocity(EDV)level[(17.02+1.63)cm/s>(24.05+1.05)cm/s,t=5.367]was relatively lower(P<0.05).In the carotid plaque ultrasound of 65 stroke patients,the detection rates of flat plaque,sclerosis plaque and mixed plaque in small infarction patients and large infarction patients were higher than those in lacunar infarction patients.In patients with small infarction,the proportion of patients with flat plaque and sclerotic plaque is higher.The proportion of patients with mixed plaques was higher in patients with massive infarction.Conclusion Carotid artery plaque can be accurately detected in the process of color Doppler ultrasound diagnosis for stroke patients,and the types of cerebrovascular lesions can be identified according to the nature and characteristics of the plaque.