颈动脉粥样硬化斑块的超声检测在缺血性脑血管病中的应用价值

Application value of ultrasonic detection of carotid atherosclerotic plaque in ischemic cerebrovascular disease

目的探讨颈动脉粥样硬化(CAS)斑块的超声检测在缺血性脑血管病(ICVD)中的应用价值。方法选取2019年8月至2021年8月于萍乡市第二人民医院确诊的50例ICVD患者作为A组,选取同时期入院体检的50例受检者(疑似合并CAS斑块)作为B组。两组均采用彩色多普勒超声仪检测,比较两组CAS程度、颈动脉内膜中层厚度(IMT)、颈动脉狭窄程度、颈脉动及脑血流量、血流参数[舒张末期血流速度(EDV)、搏动指数(PI)、收缩期峰值流速(PSV)]。结果A组斑块总积分高于B组,斑块总面积大于B组,差异有统计学意义(P<0.05)。A组颈内动脉(ICA)、颈总动脉(CCA)和颈外动脉(ECA)的IMT均厚于B组,差异有统计学意义(P<0.05)。A组ICA狭窄程度均重于B组,差异有统计学意义(P<0.05)。A组ICA、CCA、ECA及脑血流量均少于B组,差异有统计学意义(P<0.05)。A组EDV、PSV均慢于B组,PI低于B组,差异有统计学意义(P<0.05)。结论超声检测CAS斑块诊断ICVD价值较高,可根据IMT、颈动脉狭窄程度与血流参数综合判断ICVD患者的疾病程度。

Objective To investigate the value of carotid atherosclerosis(CAS)plaque detection by ultrasonography in ischemic cerebrovascular disease(ICVD).Methods 50 patients with ICVD diagnosed at the from August 2019 to August 2021 were selected as the group A,and 50 patients(suspected to have concomitant CAS plaques)who underwent physical examinations during the same period were selected as the group B.The de-gree of CAS,carotid intima-media thickness(IMT),degree of carotid stenosis,cervical pulsation and cerebral blood flow,blood flow parameters(end-diastolic blood flow velocity[EDV],pulse index[PI],peak systolic velocity[PSV])were compared between the two groups.Results The total score of plaque in the group A was higher than that in the group B,and the total area of plaque were larger than that in group B,the differences were tatistically significant(P<0.05).The IMT of internal carotid artery(ICA),common carotid artery(CCA)and external carotid artery(ECA)in the group A were thicker those in the group B,and the differences were statistically significant(P<0.05).The degree of ICA stenosis in the group A was more severe than that in the group B,and the difference was statistically significant(P<0.05).ICA,CCA,ECA and cerebral blood flow in the group A were less than those in the group B,and the differences were statistically significant(P<0.05).The EDV and PSV in the group A were slower than those in the group B,and PI was lower than that in the group B,the differences were statistically significant(P<0.05).Conclusion Ultrasound de-tection of CAS plaque has a high value in the diagnosis of ICVD,the degree of disease in patients with ICVD can be comprehensively judged accord-ing to IMT,carotid artery stenosis and blood flow parameters.