颈颅动脉超声参数评估高风险人群发生CIS危险的价值研究

Study on the value of carotid cranial artery ultrasound parameters in evaluating the risk of CIS in high-risk population

目的探讨颈颅动脉超声参数评估高风险人群发生CIS危险的价值。方法选取2018年5月~2020年5月我院274例CIS高风险人群临床资料进行回顾性研究,其中CIS组178例,非CIS组96例。统计两组颈颅动脉超声参数[颈动脉内中膜厚度(IMT)、收缩期内径、阻力指数(RI)、搏动指数(PI)]及CIS高危人群影响因素,绘制受试者工作曲线(ROC)分析颈颅动脉超声参数评估高风险人群发生CIS危险的效能,对比不同颈动脉、颅内动脉狭窄程度患者颈颅动脉超声参数,Pearson分析颈颅动脉超声参数与颈动脉、颅内动脉狭窄程度相关性。结果(1)两组在年龄、BMI、FPG、TG、TC、LDL-C、HDL-C、SBP、DBP、饮酒史、高Hcy血症史、IMT、收缩期内径、RI、PI方面相比,差异有统计学意义(P<0.05);(2)年龄、BMI、FPG、TG、TC、LDL-C、HDL-C、SBP、DBP、饮酒史、高Hcy血症史、IMT、收缩期内径、RI、PI均为CIS高风险人群发生CIS的影响因素(P<0.05);(3)ROC曲线显示,四者联合评估高风险人群发生CIS危险的效能AUC优于PI、收缩期内径、IMT、RI,为0.863(95%CI:0.821~0.906),敏感度及特异度分别为69.10%、90.62%;(4)不同颈动脉、颅内动脉狭窄程度患者IMT、收缩期内径、RI、PI相比,差异有统计学意义(P<0.05);(5)颈动脉超声参数IMT、收缩期内径、RI、PI均与颈动脉、颅动脉狭窄程度呈正相关(P<0.05)。结论CIS患者颈颅动脉超声参数呈高表达,与颈动脉、颅内动脉狭窄程度呈正相关,联合检测有助于提高CIS评估效能,指导临床治疗。

Objective To explore the value of carotid cranial artery ultrasound parameters in assessing the risk of CIS in high-risk populations.Methods The clinical data of 274 CIS high-risk populations in our hospital from May 2018 to May 2020 were selected for retrospective study,including 178 cases in the CIS group and 96 cases in the non-CIS group.The ultrasound parameters of the carotid arteries[carotid intima-media thickness(IMT),systolic diameter,resistance index(RI),pulsatility index(PI)]and influencing factors of high-risk groups of CIS in the two groups were calculated.A receiver operating curve(ROC)was drawn to analyze the effectiveness of carotid cranial artery ultrasound parameters in assessing the risk of CIS in high-risk populations.The ultrasound parameters of the carotid cranial artery in patients with different degrees of carotid and intracranial artery stenosis were compared.Pearson analyzed the correlation between the ultrasound parameters of the carotid artery and the degree of carotid and intracranial artery stenosis.Results(1)There were statistically significant differences between the two groups in age,BMI,FPG,TG,TC,LDL-C,HDL-C,SBP,DBP,history of drinking,history of hyperHcy,IMT,systolic diameter,RI,and PI(P<0.05);(2)Age,BMI,FPG,TG,TC,LDL-C,HDL-C,SBP,DBP,and history of drinking,history of hyperHcy,IMT,systolic diameter,RI,and PI were all influencing factors for the occurrence of CIS in high-risk groups of CIS(P<0.05);(3)The ROC curve showed that the AUC of the four combined evaluation of the effectiveness of CIS risk in high-risk groups was better than PI,systolic diameter,IMT,RI,which was 0.863(95%CI:0.821~0.906).The sensitivity and specificity were 69.10%and 90.62%respectively;(4)Compared with patients with different degrees of carotid artery and intracranial artery stenosis,there was a statistically significant difference in IMT,systolic diameter,RI,and PI(P<0.05);(5)(5)IMT,systolic diameter,RI and PI of the ultrasound parameters of the carotid artery were positively correlated with the degree of carotid and cranial artery stenosis(P<0.05).Conclusion The ultrasound parameters of the carotid artery in CIS patients are highly expressed,and are positively correlated with the degree of carotid artery and intracranial artery stenosis.Combined detection can help improve the efficiency of CIS evaluation and guide clinical treatment.