颈部血管超声检查对脑梗死合并颈动脉狭窄病变的诊断价值研究

Diagnosis Value of Cervical Vascular Ultrasound on Cerebral Infarction Combined with Carotid Artery Stenosis Lesions

目的:探讨颈部血管超声检查对脑梗死合并颈动脉狭窄病变的诊断价值。方法:选取2019年2月—2021年2月山东省成武县人民医院收治的345例脑梗死合并颈动脉狭窄病变患者作为研究对象,患者住院后1~7 d行颈动脉超声检查,3~7 d行数字减影血管造影检查。以数字减影血管造影检查结果为金标准,比较两种检查方法对动脉硬化、斑块的检出情况,诊断颈动脉狭窄情况及颈动脉血管超声检查的灵敏度、特异度、准确度。结果:两种检查方法动脉硬化检出率与斑块检出率比较,差异无统计学意义(P>0.05)。两种检查方法诊断颈动脉正常、轻度狭窄、中度狭窄、重度狭窄、血管闭塞情况比较,差异无统计学意义(P>0.05)。颈动脉超声检查轻度狭窄的灵敏度为56.0%,特异度为81.4%,准确度为77.3%;中度狭窄的灵敏度为98.4%,特异度为99.7%,准确度为91.8%;重度狭窄的灵敏度为90.3%,特异度为96.6%,准确度90.3%;血管完全闭塞的灵敏度为91.4%,特异度为99.3%,准确度为96.8%。结论:临床对于脑梗死合并颈动脉狭窄病变患者采用颈部血管超声检查的诊断价值较高,其特异性和准确度均较高,能准确地判定颈动脉狭窄的具体情况和狭窄程度,清晰探查到脑血管闭塞情况。

Objective:To investigate the diagnosis value of cervical vascular ultrasound on cerebral infarction combined with carotid artery stenosis lesions.Methods:A total of 345 patients with cerebral infarction and carotid artery stenosis lesions admitted to Chengwu County People's Hospital in Shandong Province from February 2019 to February 2021 were selected as the study subjects.During 1-7 d after hospitalization,the patients underwent carotid artery ultrasound;During 3-7 d after hospitalization,the patients underwent digital subtraction angiography.The results of digital subtraction angiography were used as the gold standard to compare the detection of arteriosclerosis and plaque and the diagnosis of carotid artery stenosis by the two examination methods,as well as the sensitivity,specificity and accuracy of carotid artery vascular ultrasound.Results:There was no significant difference in the detection rates of arteriosclerosis and plaque between the two examination methods(P>0.05).There was no significant difference between the two examination methods for the diagnosis of normal carotid artery,mild stenosis,moderate stenosis,severe stenosis,and vascular occlusion(P>0.05).Carotid artery ultrasound had a sensitivity of 56.0%,a specificity of 81.4%,and an accuracy of 77.3%for the mild stenosis;a sensitivity of 98.4%,a specificity of 99.7%,and an accuracy of 91.8%for the moderate stenosis;a sensitivity of 90.3%,a specificity of 96.6%,and an accuracy of 90.3%for the severe stenosis;a sensitivity of 91.4%,a specificity of 99.3%,and an accuracy of 96.8%for the complete vascular occlusion.Conclusion:The clinical diagnosis value of cervical vascular ultrasound for cerebral infarction patients with carotid artery stenosis lesions is higher,with high specificity and accuracy,it can accurately determine the specific situation and severity of carotid artery stenosis,and clearly detect the occlusion of cerebral vessels.