颈动脉彩色多普勒超声评价老年高血压患者斑块易损性与脑白质病变分级的相关性

Correlation of plaque vulnerability by carotid artery color Doppler ultrasound and WML grade in elderly hypertension patients

目的探讨颈动脉彩色多普勒超声评价老年高血压患者斑块易损性与脑白质病变(WML)分级的相关性。方法选取2018年9月~2021年9月安徽医科大学附属安庆第一人民医院收治的老年高血压患者196例,根据彩色多普勒超声检查结果分为斑块稳定组99例,斑块易损组97例。根据Fazekas量表评分分为重度组81例,非重度组115例。分析斑块稳定组与斑块易损组WML分级评分的差异性。比较重度组与非重度组基线资料、易损性总分、Crouse积分、Fazekas量表评分。多因素logistic回归分析重度WML的影响因素。结果斑块稳定组WML分级评分明显低于斑块易损组[(1.86±0.58)分vs(3.84±0.17)分,P<0.05]。重度组易损性总分、Crouse积分、Fazekas量表评分明显高于非重度组,吸烟比例明显低于非重度组(P<0.05,P<0.01)。Pearson相关性分析显示,WML分级评分与易损性总分、Crouse积分呈正相关(r=0.211,P=0.001;r=0.258,P=0.001)。多因素logistic回归分析显示,易损性总分是影响重度WML的危险因素(OR=6.772,95%CI:2.345~19.553,P=0.001)。结论斑块易损性评分与WML分级存在相关性,且易损性评分是重度WML的危险因素。

Objective To investigate the correlation of plaque vulnerability assessed by carotid artery color Doppler ultrasound examination with WML grade in elderly hypertension patients.Methods A total of 196 elderly hypertension patients admitted to Anqing First People’s Hospital from September 2018 to September 2021 were subjected in this study.According to the results of color Doppler ultrasonography, they were divided into stable plaque group(n=99) and vulnerable plaque group(n=97).Based on the grade of white matter hyperintensities on MR images by Fazekas scale score, they were assigned into severe WML group(n=81) and non-severe WML group(n=115).The differences in Fazekas scale scores were analyzed between the plaque-stable group and the plaque-vulnerable group.Baseline data, total vulnerability score, Crouse score, and Fazekas score were compared between the severe WML group and the non-severe WML group.Multivariate logistic regression analysis was used to analyze the influencing factors for severe WML.Results The Fazekas scale score was significantly lower in the stable plaque group than the vulnerable plaque group(1.86±0.58 vs 3.84±0.17,P<0.05).The severe WML group had obviously higer total vulnerability score, Crouse score, and Fazekas scale score, but lower proportion of smoking than the non-severe WML group(P<0.05,P<0.01).The results of Pearson correlation analysis showed that the WML grading score was positively correlated with total vulnerability score and Crouse score(r=0.211,P=0.001;r=0.258,P=0.001).Multivariate logistic regression analysis indicated that total vulnerability score was a risk factor for severe WML(OR=6.772,95%CI:2.345-19.553,P=0.001).Conclusion Plaque vulnerability score is correlated with WML grade, and vulnerability score is a risk factor for severe WML.