颈动脉易损斑块风险模型的构建及与急性脑梗死患者认知障碍和预后的关系

Construction of carotid vulnerable plaque risk model and its relationship with cognitive impairment and prognosis in patients with acute cerebral infarction

[目的]研究颈动脉易损斑块与急性脑梗死(ACI)患者认知障碍和预后的关系。[方法]将2018年7月—2020年7月于连云港市第一人民医院诊断为ACI伴颈动脉易损斑块的患者180例作为观察组,另选取180例经健康体检诊断为不稳定斑块的研究人员作为对照组,分别对两组不稳定斑块积分比、斑块最大长度、斑块最大厚度、溃疡斑块、面积狭窄、狭窄处峰值流速以及阻力指数进行比较。[结果]两组患者的不稳定斑块积分比、斑块最大长度、斑块最大厚度、溃疡斑块、面积狭窄、狭窄处峰值流速以及阻力指数之间的差异存在统计学意义(P<0.05)。多因素分析显示,高不稳定斑块积分比、斑块最大长度、斑块最大厚度、溃疡斑块、面积狭窄处峰值流速以及阻力指数均是造成颈动脉易损斑块的危险因素。观察组患者的认知障碍(χ^(2)=11.432,P=0.001)和预后不良(χ^(2)=14.362,P=0.000)的发生率显著高于对照组。相关性分析显示,ACI患者的颈动脉易损斑块与认知障碍以及预后不良呈现显著的相关性。[结论]颈动脉易损斑块与ACI患者认知障碍和预后不良呈现显著的相关性,高不稳定斑块积分比、斑块最大长度、斑块最大厚度、溃疡斑块、面积狭窄、狭窄处峰值流速以及阻力指数均是造成颈动脉易损斑块的危险因素,建议对此类患者及时进行临床干预。

Aim To study the construction of carotid vulnerable plaque risk model and its relationship with cognitive impairment and prognosis in patients with acute cerebral infarction(ACI).Methods 180 patients with carotid vulnerable plaques in Lianyungang First People s Hospital from July 2018 to July 2020 were selected as observation group,and another 180 patients with unstable plaques who underwent physical examination were selected as control group.The unstable plaque integral ratio,the maximum length of plaques,the maximum thickness of plaques,ulcer plaques,area stenosis,peak flow velocity at stenosis and resistance index were compared to study the construction of carotid vulnerable plaque risk model and its relationship with cognitive impairment and prognosis in patients with ACI.Results There were significant differences between the two groups in unstable plaque integral ratio,maximum plaque length,maximum plaque thickness,ulcer plaque,area stenosis,peak flow velocity at stenosis and resistance index(P<0.05).Multivariate analysis showed that high unstable plaque integral ratio,maximum plaque length,maximum plaque thickness,ulcer plaque,peak flow velocity at area stenosis and resistance index were the risk factors for carotid vulnerable plaque.The incidence of cognitive impairment(χ^(2)=11.432,P=0.001)and poor prognosis(χ^(2)=14.362,P=0.000)in the observation group was significantly higher than those in the control group.Correlation analysis showed that carotid vulnerable plaques in ACI patients were significantly correlated with cognitive impairment and prognosis.Conclusions Carotid vulnerable plaque is significantly correlated with cognitive impairment and prognosis in patients with ACI.High unstable plaque integral ratio,maximum plaque length,maximum plaque thickness,ulcer plaque,area stenosis,peak flow velocity at stenosis and resistance index are all risk factors for carotid vulnerable plaque,it is suggested that clinical intervention should be carried out in time for such patients.