彩色多普勒超声对于缺血性脑血管病患者颈动脉病变的诊断价值分析

Value of Color Doppler Ultrasound in the Diagnosis of Carotid Artery Disease in Patients with Ischemic Cerebrovascular Disease

目的分析对于缺血性脑血管病患者颈动脉病变诊断中应用彩色多普勒超声的临床诊断价值。方法分析2019年1月-2020年6月共收治的80例缺血性脑血管病患者的影像学资料,按照颈动脉血管狭窄情况分为轻中度组(n=43)、重度组(n=37),再收集同时段入院接受健康体检的正常对象共80名纳入对照组。三组均接受彩色多普勒超声检查,以数字减影血管造影诊断结果作为参照,评价及对比三组的经内动脉及颈总动脉的血流信号、动脉内-中膜厚度、血管反应性指标。结果三组的颈内动脉内径、颈总动脉内径、动脉内-中膜厚度比较无明显差异性(P>0.05);重度组的颈内动脉内径、颈总动脉内径、动脉内-中膜厚度与对照组比较存在差异性(P<0.05);重度组的血管反应性低于对照组(P<0.05);三组的舒张末期最低血流速度、收缩期最大血流速度、平均血流速度比较无明显差异性(P>0.05);重度组的舒张末期最低血流速度、收缩期最大血流速度、平均血流速度均高于对照组(P<0.05)。结论对于缺血性脑血管病患者应用彩色多普勒超声,可通过血流动力学参数改变早期诊断出颈动脉病变,且可正确反映出病变程度,可为后续临床制定诊疗计划提供可靠理论依据,是一种理想的诊断选择。

Objective To analyze the clinical value of color Doppler ultrasound in the diagnosis of carotid artery disease in patients with ischemic cerebrovascular disease. Methods The imaging data of 80 patients with ischemic cerebrovascular disease admitted to our hospital from January 2019 to June 2020 were retrospectively analyzed. According to the carotid artery stenosis, they were divided into mild to moderate group(n=43) and severe group(n=37). At the same time, 80 healthy subjects were collected and included in the control group. All the three groups were examined by color Doppler ultrasound, and the blood flow signals, intima-media thickness and vascular reactivity indexes of the three groups were evaluated and compared with the diagnostic results of digital subtraction angiography. Results There was no significant difference in the internal carotid artery diameter, common carotid artery diameter and intima-media thickness among the three groups(P>0.05);the internal carotid artery diameter, common carotid artery diameter and intima-media thickness of the severe group were different from those of the control group(P<0.05);the vascular reactivity of the severe group was lower than that of the control group(P<0.05);the minimum end diastolic blood flow velocity of the three groups was lower than that of the control group There was no significant difference between the two groups(P>0.05);the lowest diastolic blood flow velocity, maximum systolic blood flow velocity and average blood flow velocity in severe group were higher than those in control group(P<0.05). Conclusions The application of color Doppler ultrasound in patients with ischemic cerebrovascular disease can early diagnose the carotid artery disease through the change of hemodynamic parameters, and can correctly reflect the extent of the disease, which can provide a reliable theoretical basis for the follow-up clinical diagnosis and treatment plan, and is an ideal diagnosis choice.