超声检查对短暂性脑缺血(TIA)患者颈部大动脉病变与卒中危险性的相关性分析

Correlation Between Carotid Artery Disease and Stroke Risk in Patients with Transient Cerebral Ischemia(TIA)by Ultrasonography

目的:应用超声检查评估短暂性脑缺血发作(TIA)患者颈部大动脉病变与卒中危险性的关系。方法:选择我院2020年11月-2022年3月收治的150例TIA患者作为观察组,其中颈动脉系统TIA患者80例(观察1组),椎-基底动脉系统TIA患者70例(观察2组)。同期选择我院体检的健康者70例作为对照组。对所有受试者行常规颈动脉超声检查,比较观察组与对照组颈动脉内中膜厚度(IMT)、斑块性质、斑块分布、动脉狭窄程度,比较观察组各亚组斑块分布情况,同时记录两组C反应蛋白(CRP)、同型半胱氨酸(Hcy)、尿酸(Ua)、纤维蛋白原(Fib)、白细胞(WBC)计数、总胆固醇(TC)、高/低密度脂蛋白胆固醇(H/LDL-C)、甘油三酯(TG)、吸烟指数、格拉斯哥昏迷评分(GCS)及中国卒中量表(CSS)评分等危险因素,评估各指标与TIA患者颈动脉狭窄及斑块性质的关系。结果:观察组双侧IMT值、不稳定斑块、颈动脉中、重度狭窄的检出率均高于对照组(P<0.05);观察组各亚组斑块分布差异有统计学意义,观察1组锁骨下动脉起始处斑块的检出率较观察2组更低(P<0.05);不同循环系统TIA患者CRP、Hcy、Ua、Fib、WBC计数、TC、H/LDL-C、TG、吸烟指数、GCS及CSS评分差异无统计学意义(P>0.05);不同狭窄程度、不同斑块性质TIA患者CRP、Hcy、Ua、Fib、WBC、LDL-C、GCS评分及CSS评分对比差异有统计学意义(P<0.05)。结论:TIA患者颈部大动脉病变与卒中发生密切相关,超声能够准确评估TIA颈动脉狭窄程度及斑块性质,早期识别卒中风险,对于防治脑卒中有指导意义。

Objective:To evaluate the relationship between carotid artery disease and stroke risk in patients with transient ischemic attack(TIA).Methods:150 patients with TIA in our hospital from November 2020 to March 2022 were selected as the observation group,including 80 patients with TIA in carotid system(observation group 1)and 70 patients with TIA in vertebrobasilar system(observation group 2).At the same time,70 healthy subjects were selected as the control group.Routine carotid ultrasound examination was performed on all subjects.The carotid intima-media thickness(IMT),plaque properties,plaque distribution and arterial stenosis of the observation group and the control group were compared.The plaque distribution of each subgroup of the observation group was compared.At the same time,C-reactive protein(CRP),homocysteine(Hcy),uric acid(UA),fibrinogen(FIB),white blood cell(WBC)count,total cholesterol(TC)and High/low density lipoprotein cholesterol(h/ldl-c),triglyceride(TG),smoking index,Glasgow Coma Scale(GCS)and Chinese Stroke Scale(CSS)scores were used to evaluate the relationship between these indicators and carotid stenosis and plaque properties in patients with TIA.Results:the detection rates of bilateral IMT value,unstable plaque and moderate and severe carotid stenosis in the observation group were higher than those in the control group(P<0.05);There was significant difference in plaque distribution among subgroups in the observation group.The detection rate of plaque at the beginning of subclavian artery in the observation group 1 was lower than that in the observation group 2(P<0.05);There was no significant difference in CRP,Hcy,UA,FIB,WBC count,TC,h/ldl-c,TG,smoking index,GCS and CSS scores among patients with TIA of different circulatory systems(P>0.05);There were significant differences in CRP,Hcy,UA,FIB,WBC,LDL-C,GCS and CSS scores among patients with TIA of different stenosis degree and plaque nature(P<0.05).Conclusion:carotid artery disease in patients with TIA is closely related to stroke.Ultrasound can accurately evaluate the degree of carotid artery stenosis and the nature of plaque,and early identify the risk of stroke,which has guiding significance for the prevention and treatment of stroke.