探讨颈部血管彩超联合经颅多普勒超声对缺血性脑卒中的诊断价值

Diagnostic value of cervical vascular color Doppler ultrasound combined with transcranial Doppler ultrasound in ischemic stroke

目的 探讨绿色通道背景下采用颈部血管彩超(CUS)联合经颅多普勒超声(TCD)对缺血性脑卒中的诊断效果。方法 选取2020年2月—2021年2月郑州人民医院收治的80例缺血性脑卒中患者作为观察组研究对象,另选取本院同期80例非缺血性脑卒中患者作为对照组研究对象,所有患者均于绿色通道背景下行CUS与TCD检查。比较2组患者颈动脉内中膜增、颈动脉狭窄与颅内动脉狭窄情况,并计算2种检查方法单独应用与联合应用对缺血性脑卒中的诊断效能。结果 91.25%的观察组患者存在颈动脉内中膜增厚,多于对照组的30.00%,且差异具有统计学意义(P<0.05)。2组患者颈动脉狭窄情况、颅内动脉狭窄情况的差异均具有统计学意义(均P<0.05),观察组患者颈动脉中重度狭窄的人数比例及颅内动脉中重度狭窄的人数比例均高于对照组。CUS诊断的敏感度为75.00%,特异度为65.00%,准确度为70.00%;TCD诊断的敏感度为71.25%,特异度为66.25%,准确度为68.75%;二者联合应用诊断的敏感度为93.75%,特异度为90.00%,准确度为91.88%。二者联合应用的敏感度、特异度以及准确度均更高(均P<0.05)。结论 CUS联合TCD检查对缺血性脑卒中具有较好的诊断效能,可协助医师了解患者颈动脉与颅内动脉狭窄情况,为临床诊断提供可靠依据,具有较高的临床推广价值。

Objective To investigate the diagnostic value of cervical vascular color Doppler ultrasound(CUS) combined with transcranial Doppler ultrasound(TCD) on ischemic stroke in the context of emergency access. Methods Eighty patients with ischemic stroke admitted to Zhengzhou People’s Hospital from Feb. 2020 to Feb. 2021 were selected as subjects in the observation group, and another 80 patients with non-ischemic stroke were selected as controls in the control group. All patients were examined by CUS and TCD under emergency access. The proportion of carotid artery intima-media thickening, the severity of carotid artery stenosis and intracranial artery stenosis were compared between the two groups, and the diagnostic efficacy of the two examination methods alone and in combination for ischemic stroke was calculated. Results Carotid artery intima-media thickening of the patients in the observation group(91.25%) was significantly higher than that in the control group(30.00%, P<0.05). There were statistically significant differences in carotid artery stenosis and intracranial artery stenosis between the two groups(all P<0.05). The proportion of patients with moderate to severe carotid artery stenosis and the proportion of patients with moderate to severe intracranial artery stenosis in the observation group were higher than those in the control group. The sensitivity, specificity, and accuracy of CUS were 75.00%, 65.00%, and 70.00%, respectively. The sensitivity, specificity, and accuracy of TCD were 71.25%, 66.25%, and 68.75%, respectively. The sensitivity, specificity, and accuracy of TCD were 93.75%, 90.00%, and 91.88%, respectively. The sensitivity, specificity, and accuracy of the combination of the two procedures were significantly higher(all P<0.05). Conclusion CUS combined with TCD has good diagnostic efficacy for ischemic stroke, which can assist physicians to observe the carotid artery and intracranial artery stenosis and provide reliable evidence for clinical diagnosis. These benefits hold much promise for a wider application of this procedure clinically.