颈部血管超声检查对急性脑卒中患者术后不良心脑血管事件的预测价值研究

Study on the Predictive Value of Cervical Vascular Ultrasound in Postoperative Adverse Cardiovascular and Cerebrovascular Events of Patients with Acute Stroke

目的探讨颈部血管超声检查对急性脑卒中患者术后不良心脑血管事件的预测价值。方法96例急性脑卒中患者均行颈部血管超声检查,根据术后1年内是否发生不良心脑血管事件分为发生组和未发生组,比较两组动脉管腔内径-内中膜厚度(IMT)及血流参数[收缩期峰值流速(VS)、舒张期末流速(VD)、搏动指数(PI)、阻力指数(RI)]。绘制ROC曲线分析各指标对急性脑卒中患者术后不良心脑血管事件的预测价值。结果发生组的动脉粥样硬化占比及IMT均高于未发生组(P<0.05)。发生组颈内动脉和颈外动脉的VS、VD均低于未发生组,颈内动脉和颈外动脉的PI均高于未发生组(P<0.05)。ROC曲线分析显示,IMT及颈内动脉和颈外动脉的VS、VD、PI对急性脑卒中患者术后不良心脑血管事件均具有显著的预测价值(P<0.05)。结论颈部血管超声检查可有效反映颈动脉血流特征,对急性脑卒中患者术后不良心脑血管事件具有显著的预测价值。

Objective To explore the predictive value of cervical vascular ultrasound in postoperative adverse cardiovascular and cerebrovascular events of patients with acute stroke.Methods 96 patients with acute stroke were given cervical vascular ultrasound,and were divided into occurrence group and non-occurrence group according to adverse cardiovascular and cerebrovascular events occurred within one year after operation or not.The arterial lumen diameter-intima-media thickness(IMT)and blood flow parameters[peak systolic velocity(VS),end diastolic velocity(VD),pulsatility index(PI),resistance index(RI)]were compared between the two groups.ROC curve was drawn to analyze the predictive value for postoperative adverse cardiovascular and cerebrovascular events in patients with acute stroke.Results The proportion of atherosclerosis and IMT in the occurrence group were higher than those in the non-occurrence group(P<0.05).The VS and VD of internal carotid artery and external carotid artery in the occurrence group were lower than those in the non-occurrence group,while the PI of internal carotid artery and external carotid artery were higher than those in the non-occurrence group(P<0.05).ROC curve analysis showed that IMT,VS,VD and PI of internal carotid artery and external carotid artery had significant predictive value for postoperative adverse cardiovascular and cerebrovascular events in patients with acute stroke(P<0.05).Conclusions Cervical vascular ultrasound can effectively reflect the characteristics of carotid blood flow,and has significant predictive value for postoperative adverse cardiovascular and cerebrovascular events in patients with acute stroke.