颈动脉斑块造影评价新生血管与缺血性脑卒中的关系

Carotid plaque angiography evaluation of relationship between neovascularization and ischemic stroke

目的探讨颈动脉斑块造影评价新生血管与缺血性脑卒中的关系。方法回顾性分析2021-01—2021-12郑州大学第二附属医院收治的62例伴颈动脉斑块的缺血性脑卒中患者(观察组)的临床资料,并选取同期60例有颈动脉斑块未发脑卒中患者为对照组。所有患者均予以超声检查,测定颈动脉内中膜厚度(IMT),采用超声造影(CEUS)评估有颈动脉斑块患者斑块内新生血管情况。比较2组颈动脉斑块检查情况,评估颈动脉斑块患者斑块内新生血管与病情严重程度[美国国立卫生院卒中量表(NIHSS)]、预后状况[改良Rankin量表(mRS)]的关系。结果观察组颈动脉斑块内新生血管Ⅱ、Ⅲ级占比高于对照组(P<0.05),2组斑块厚度、低回声斑块占比对比差异无统计学意义(P>0.05),观察组DAT、DTTP均低于对照组(P<0.05),观察组斑块增强强度高于对照组(P<0.05)。Spearman相关性分析显示,斑块内新生血管分级与脑卒中患者NIHSS、mRS得分均呈正相关关系(P<0.05)。Pearson相关分析显示,DAT、DTTP与脑卒中患者NIHSS、mRS得分均呈负相关关系(P<0.05),斑块增强强度与脑卒中患者NIHSS、mRS得分均呈正相关关系(P<0.05)。结论脑卒中患者颈动脉斑块内新生血管密度更高,颈动脉斑块内新生血管与患者病情严重程度和预后有关。

Objective To explore the carotid plaque angiography evaluation of relationship between neovascularization and ischemic stroke. Methods The clinical data of 62 ischemic stroke patients with carotid plaques(observation group)admitted between January 2021 and December 2021 were retrospectively analyzed, and 60 patients with carotid plaques but without stroke during the same period were selected as control group. All patients were examined by ultrasound to measure the carotid intima-media thickness(IMT),and contrast-enhanced ultrasound(CEUS)was used to evaluate the neovascularization in patients with carotid plaques. The examination status of carotid plaques were compared between the two groups,and the relationship between plaque neovascularization and disease severity(National Institutes of Health stroke scale,NIHSS)and prognosis(modified Rankin Scale,mRS)was evaluated among patients with carotid plaques. Results The proportions of neovascularization grade Ⅱ and grade Ⅲ in carotid plaques in observation group were higher than those in control group(P< 0.05). There were no statistically significant differences in plaque thickness and proportion of low echo plaque between the two groups(P>0.05). The DAT and DTTP in observation group were lower than those in control group (P<0.05),and the plaque enhancement intensity in observation group was higher than that in control group(P< 0.05). Spearman correlation analysis showed that plaque neovascularization grading was positively correlated with scores of NIHSS and MRS in stroke patients(P<0.05). Pearson correlation analysis showed DAT and DTTP were negatively correlated with scores of NIHSS and mRS of stroke patients(P<0.05),and plaque enhancement intensity was positively correlated with scores of NIHSS and MRS of stroke patients(P<0.05). Conclusion The density of neovascularization in carotid plaques is higher in patients with stroke. Neovascularization in carotid plaques is related to the disease severity and prognosis of patients.