颈部血管彩色多普勒超声在缺血性脑卒中患者颈部血管狭窄评估中的应用

Application of color Doppler ultrasound in the evaluation of cervical vascular stenosis in patients with ischemic stroke

目的探讨颈部血管彩色多普勒超声在缺血性脑卒中患者颈部血管狭窄评估中的应用价值。方法选择临海市中医院2018年2月至2019年5月收治的缺血性脑卒中患者98例为研究组,将同期体检健康者98例为对照组。两组均行颈部血管彩色多普勒超声检查,比较两组双侧颈总动脉(CCA)、颈内动脉(ICA)、颈外动脉(ECA)内膜中层厚度(IMT),比较两组颈动脉出现内膜增厚、斑块、狭窄的情况。结果研究组双侧CCA、ICA、ECA的IMT值[(1.28±0.26)mm和(1.31±0.32)mm、(1.22±0.24)mm和(1.23±0.26)mm、(1.03±0.24)mm和(1.08±0.26)mm]均明显高于对照组[(0.84±0.19)mm和(0.82±0.22)mm、(0.81±0.19)mm和(0.82±0.20)mm、(0.68±0.16)mm和(0.71±0.19)mm](t=13.526、12.491、13.259、12.373、12.012、11.374,均P<0.05);研究组颈动脉内膜增厚、斑块的发生率[43.88%(43/98)、46.94%(46/98)]均明显高于对照组[25.51%(25/98)、5.10%(5/98)](χ^(2)=7.296、44.554,均P<0.05);研究组颈动脉轻、中、重以及总狭窄率[20.41%(20/98)、33.67%(33/98)、41.84%(41/98)、95.92%(94/98)]均明显高于对照组[8.16%(8/98)、5.10%(5/98)、1.02%(1/98)、14.29%(14/98)](χ^(2)=6.000、25.594、48.485、64.460,均P<0.05)。结论应用颈部血管彩色多普勒超声能够有效评估缺血性脑卒中患者颈部血管内膜增厚、斑块形成以及狭窄情况,具有重要的临床诊断意义,对后续的临床诊疗具有指导意义,值得在临床进一步推广使用。

Objective To investigate the application value of color Doppler ultrasound in the evaluation of cervical vascular stenosis in patients with ischemic stroke.Methods A total of 98 patients with ischemic stroke who received treatment from February 2018 to May 2019 in the Linhai Hospital of Traditional Chinese Medicine were included in the study group.Additional 98 healthy controls who concurrently received health examination were included in the control group.Both study and control groups received color Doppler ultrasound examination of the neck.The intima-media thickness of bilateral common carotid artery,internal carotid artery and external carotid artery and the incidences of intimal thickening,plaque and stenosis were compared between the two groups.Results The intima-media thickness of bilateral common carotid artery[(1.28±0.26)mm and(1.31±0.32)mm],internal carotid artery[(1.22±0.24)mm and(1.23±0.26)mm]and external carotid artery[(1.03±0.24)mm and(1.08±0.26)mm]in the study group were significantly higher than those in the control group[(0.84±0.19)mm and(0.82±0.22)mm,(0.81±0.19)mm and(0.82±0.20)mm,(0.68±0.16)mm and(0.71±0.19)mm;t=13.526,12.491,13.259,12.373,12.012,11.374,all P<0.05].The incidence of carotid intima thickening[43.88%(43/98)]and the incidence of intimal plaque[46.94%(46/98)]in the study group were significantly higher than those in the control group[25.51%(25/98),5.10%(5/98),χ^(2)=7.296,44.554,both P<0.05].The incidence of mild[20.41%(20/98)],moderate[33.67%(33/98)],severe carotid artery stenosis[41.84%(41/98)]as well as total stenosis rate[95.92%(94/98)]in the study group were significantly higher compared with the control group[8.16%(8/98),5.10%(5/98),1.02%(1/98),14.29%(14/98),χ^(2)=6.000,25.594,48.485,64.460,all P<0.05].Conclusion Color Doppler ultrasound can be used to effectively evaluate cervical intimal thickening,plaque formation,and stenosis in patients with ischemic stroke.It is of important clinical diagnostic significance,has guiding significance for clinical diagnosis and treatment,and therefore is worthy of clinical promotion.