颈动脉超声联合经颅多普勒超声对缺血性脑血管疾病的诊断价值分析

Value of carotid ultrasound combined with transcranial Doppler ultrasound in diagnosis of ischemic cerebrovascular disease

目的探讨颈动脉超声联合经颅多普勒超声(TCD)对缺血性脑血管疾病的诊断价值。方法选取2019年1月至2020年6月中国人民武装警察部队海警总队医院收治的非急性缺血性脑血管疾病患者140例为研究对象,患者入院后均行数字减影血管造影(DSA)、颈动脉超声及TCD检查,以DSA检查为诊断金标准。比较单独使用颈动脉超声、TCD及两者联用的灵敏度、特异度及准确度。结果颈动脉超声诊断缺血性脑血管疾病的灵敏度、特异度、准确度分别为80.00%(92/115)、84.00%(21/25)、80.71%(113/140),TCD分别为74.78%(86/115)、76.00%(19/25)、75.00%(105/140),而颈动脉超声联合TCD分别为97.39%(112/115)、92.00%(23/25)、96.43%(135/140),颈动脉超声联合TCD的灵敏度、特异度、准确度较两者单纯应用均有明显提升(均P<0.05)。颈动脉超声联合TCD与DSA检查结果的一致性较好,Kappa值为0.873。结论颈动脉超声联合TCD在缺血性脑血管疾病中的诊断准确率与DSA相接近,相比DSA检查具有无创、费用低等优势。

Objective To investigate the diagnostic value of carotid ultrasound combined with transcranial Doppler ultrasound(TCD)in ischemic cerebrovascular disease.Methods One hundred and forty patients with ischemic cerebrovascular disease diagnosed in our hospital from January 2019 to June 2020 were enrolled in the study.All patients underwent angiography(DSA),carotid ultrasound and TCD examination after admission.With DSA as the diagnostic gold standard,the diagnostic sensitivity,specificity and accuracy of carotid ultrasound alone,TCD and their combination for ischemic cerebrovascular disease were compared.Results The sensitivity,specificity and accuracy of carotid ultrasound were 80.00%(92/115),84.00%(21/25)and 80.71%(113/140)respectively;those of TCD were 74.78%(86/115),76.00%(19/25)and 75.00%(105/140),those of carotid ultrasound combined with TCD were 97.39%(112/115),92.00%(23/25)and 96.43%(135/140),respectively.The diagnostic sensitivity,specificity and accuracy of carotid ultrasound combined with TCD were significantly higher than those of single application(all P<0.05).Conclusion The diagnostic accuracy of carotid ultrasound combined with TCD for ischemic cerebrovascular disease is close to that of DSA,however,it has advantages of non-invasion and cost-effectiveness.