经颅多普勒超声检查与血脂指标检测在缺血性脑血管病中的应用价值

Application value of transcranial Doppler ultrasonography and blood lipid index detection in ischemic cerebrovascular disease

目的探究经颅多普勒超声检查与三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)水平检测在缺血性脑血管病中的诊断价值。方法选取2019年1月至2020年10月江苏大学附属武进医院收治的72例缺血性脑血管病患者作为观察组,另选取同期进行健康体检的50例健康者作为对照组,开展前瞻性研究。所有研究对象以数字减影血管造影术(DSA)检查结果为金标准,并均行经颅多普勒超声检查及血清TG、TC、LDL水平检测。比较两组研究对象血脂指标、经颅多普勒超声检测结果;以DSA检测为金标准,比较经颅多普勒超声联合TG、TC、LDL水平检测诊断缺血性脑血管病的诊断符合率,经颅多普勒超声诊断脑血管不同狭窄程度的准确率。结果两组研究对象血清TG、TC水平比较,差异均无统计学意义(均P>0.05);观察组患者血清LDL水平显著高于对照组;观察组患者椎动脉和基底动脉搏动指数显著高于对照组,且椎动脉和基底动脉平均血流速度显著低于对照组;经颅多普勒超声联合TG、TC、LDL水平检测诊断缺血性脑血管病的诊断符合率显著高于单纯TG、TC、LDL检测(均P<0.05);经颅多普勒超声检测轻度狭窄、中度狭窄、重度狭窄、完全闭塞诊断符合率分别为83.87%、88.89%、84.38%、90.00%,总诊断符合率为86.31%。结论缺血性脑血管病患者血清LDL水平、椎动脉和基底动脉搏动指数会异常升高,椎动脉和基底动脉平均血流速度会显著降低,施行经颅多普勒超声检测与TG、TC、LDL水平联合检测有助于提升其诊断准确率。

Objective To explore the diagnostic value of transcranial Doppler ultrasonography and the detedtion of triglyceride(TG),total cholesterol(TC)and low density lipoprotein(LDL)levels in ischemic cerebrovascular disease.Methods A total of 72 patients with ischemic cerebrovascular disease admitted to Wujin Hospital Affiliated to Jiangsu University from January 2019 to October 2020 were selected as the observation group,and 50 healthy subjects who underwent physical examination in the hospital during the same period were selected as the control group,carried out a prospective research.All subjects used the detection result of digital subtraction angiography(DSA)as the gold standard.All subjects underwent transcranial Doppler ultrasonography,and TG,TC,and LDL levels detection.Compared the blood lipid indexes and the results of transcranial Doppler ultrasound of subjects in the two groups;used DSA test as the gold standard,compared the diagnostic coincidence rate of transcranial Doppler ultrasonography combined with TG,TC and LDL levels detection in the diagnosis of ischemic cerebrovascular disease,and the accuracy rate of transcranial Doppler ultrasonography in the diagnosis of different degrees of cerebrovascular stenosis.Results There was no statistically significant difference in serum TG and TC levels of subjects between the two groups(all P>0.05);The serum LDL level in the observation group was significantly higher than that in the control group;the pulsatility index of vertebral artery and basilar artery of patients in the observation group were significantly higher than those in the control group,and the average blood flow velocity of the vertebral artery and basilar artery were significantly lower than those in the control group;the diagnostic coincidence rate of transcranial Doppler ultrasonography combined with TG,TC,LDL levels detection in the diagnosis of ischemic cerebrovascular disease was significantly higher than that of TG,TC,LDL levels detection(all P<0.05);The diagnostic coincidence rate of mild stenosis,moderate stenosis,severe stenosis and complete occlusion detected by transcranial Doppler ultrasound were 83.87%,88.89%,84.38%and 90.00%,respectively,and the total diagnostic coincidence rate was 86.31%.Conclusion In patients with ischemic cerebrovascular disease,the serum LDL level,vertebral artery and basilar artery pulsatility index increased abnormally,and the average blood flow velocity of vertebral artery and basilar artery reduced significantly.Transcranial Doppler ultrasound detection combined with TG,TC,LDL levels detection can help to improve the accuracy of its diagnosis.