彩超对颈动脉粥样硬化与缺血性脑血管疾病的诊断价值

Diagnostic Value of Color Doppler Ultrasound in Carotid Atherosclerosis and Ischemic Cerebrovascular Diseases

目的探讨彩超对颈动脉粥样硬化与缺血性脑血管疾病的诊断价值。方法选择2017年3月至2019年3月医院收治的350例缺血性脑血管疾病患者作为研究组,均接受颈动脉彩超检测舒张期峰值流速(EDV)、收缩期峰值流速(PSV)、颈总动脉(CCA)、内-中膜厚度(IMT)值,观察粥样硬化斑块形成情况及斑块的性质。选择同期200名健康人作为对照组。结果研究组EDV为(4.94±0.83)cm/s、PSV为(83.94±7.38)cm/s、CCA为(7.04±0.66)mm,对照组分别为(5.84±0.74)cm/s、(50.93±9.15)cm/s、(5.93±0.92)mm,组间比较差异均有统计学意义(P<0.05)。研究组IMT>1.0 mm的比例为73.14%,粥样硬化斑块形成的比例为69.71%,其中软斑152枚,溃疡斑113枚,硬斑102枚,扁平斑68枚;对照组IMT>1.0 mm的比例为31.00%,粥样硬化斑块形成的比例为20.50%,其中软斑11枚,溃疡斑0枚,硬斑26枚,扁平斑18枚,组间比较差异有统计学意义(P<0.05)。以脑血管造影作为金标准,彩超对缺血性脑血管疾病的灵敏度与特异度分别为83.94%、70.41%。结论彩超能比较灵敏地发现颈动脉粥样硬化病灶,是诊断缺血性脑血管疾病可靠的方法。

Objective To investigate the diagnostic value of color doppler ultrasound in carotid atherosclerosis and ischemic cerebrovascular diseases.Methods From March 2017 to March 2019,350 patients with ischemic cerebrovascular disease were selected as the research group.Carotid artery ultrasound was performed to detect diastolic peak flow rate(EDV),systolic peak flow rate(PSV),common carotid artery(CCA)and IMT.The formation of atherosclerotic plaques and their properties were observed.200 healthy people in the same period were selected as the control group.Results In the study group,the EDV was(4.94±0.83)cm/s,the PSV was(83.94±7.38)cm/s,and the CCA was(7.04±0.66)mm,while that in the control of the study group was(5.84±0.74)cm/s,(50.93±9.15)cm/s,(5.93±0.92)mm,and the comparison with statistical significance(P<0.05).In the study group,the proportion of IMT>1.0 mm was 73.14%,and the proportion of atherosclerotic plaques was 69.71%,including 152 soft plaques,113 ulcer plaques,102 hard plaques,and 68 flat plaques.In the control group,the proportion of IMT>1.0 mm was 31.00%,and the proportion of atherosclerotic plaques was 20.50%,including 11 soft plaques,0 ulcer plaques,26 hard plaques,and 18 flat plaques,and the comparison with statistical significance(P<0.05).Taking cerebral angiography as the gold standard,the sensitivity and specificity of color doppler ultrasound for ischemic cerebrovascular diseases were 83.94%and 70.41%,respectively.Conclusion Color doppler ultrasound can detect carotid atherosclerosis sensitively and is a reliable method to diagnose ischemic cerebrovascular disease.