TCD联合颈动脉超声评估缺血性脑卒中患者颅内外血管的价值

Value of TCD combined with carotid ultrasound in evaluating intracranial and extracranial blood vessels in patients with cerebral ischemic stroke

目的研究经颅多普勒超声(TCD)联合颈动脉超声(CU)评估缺血性脑卒中(CIS)患者颅内外血管的价值。方法回顾性抽取2019年3月至2022年2月河南省直第三人民医院收治的CIS患者126例作为CIS组,同时以1∶1配比抽取收治的存在头痛、头晕、肢体活动障碍等症状的非CIS患者126例作为非CIS组。两组患者均给予TCD联合CU检查。比较两组内中膜增厚、斑块形成发生率、颅内血管狭窄发生率、狭窄程度、颈动脉斑块情况,比较两组TCD、CU单独及联合诊断CIS的检出率。结果CIS组内中膜增厚率(90.48%,114/126)、斑块形成发生率(84.92%,107/126)高于非CIS组(28.57%,36/126;35.71%,45/126),P<0.05。CIS组颅内血管狭窄发生率(100.00%,126/126)高于非CIS组(45.24%,57/126),P<0.05。CIS组颅内血管轻度狭窄率(8.73%,11/126)低于非CIS组(37.30%,47/126),中度狭窄率(30.16%,38/126)、重度狭窄或闭塞率(61.11%,77/126)高于非CIS组(7.94%,10/126;0.00%,0/126),P<0.05。CIS组溃疡、均质回声、钙化、不均质回声斑块检出率均高于非CIS组(P均<0.05);TCD联合CU诊断CIS的检出率(95.24%,120/126)高于TCD诊断(75.40%,95/126)和CU诊断(66.67%,84/126),P<0.05。结论TCD联合CU应用于CIS诊断中,可评估斑块形成、颅内血管狭窄及狭窄程度等情况,显著提高疾病检出率,为临床采取针对性治疗提供参考依据。

Objective To investigate the value of transcranial Doppler(TCD)combined with carotid ultrasound(CU)in evaluating intracranial and extracranial blood vessels in patients with cerebral ischemic stroke(CIS).Methods A total of 126 CIS patients treated in the Third People’s Hospital of Henan Province from March 2019 to February 2022 were retrospectively selected as the CIS group,and 126 non-CIS patients with headache,dizziness,limb mobility disorder and other symptoms were selected as the non-CIS group with a ratio of 1∶1.Both groups were given TCD combined with CU examination.The intima-media thickening,the incidence of plaque formation,the incidence of intracranial vascular stenosis,the degree of stenosis,the condition of carotid plaque,and the detection rate of CIS diagnosed by TCD alone,CU alone and combination of them were compared between the two groups.Results Intima-media thickening rate and plaque formation rate in the CIS group(90.48%,114/126;84.92%,107/126)were higher than those in the non-CIS group(28.57%,36/126;35.71%,45/126),P<0.05.The incidence of intracranial vascular stenosis in the CIS group was 100.00%(126/126),which was higher than the 45.24%(57/126)in the non-CIS group(P<0.05).The rate of mild intracranial vascular stenosis in the CIS group was 8.73%(11/126),which was lower than the 37.30%(47/126)in the non-CIS group(P<0.05).The moderate stenosis rate and severe stenosis or occlusion rate in the CIS group(30.16%,38/126;61.11%,77/126)were higher than those in the non-CIS group(7.94%,10/126;0.00%,0/126),P<0.05.The detection rates of ulcer,homogeneous echo,calcification and heterogeneous echogenic plaques in the CIS group were higher than those in the non-CIS group(all P<0.05).The detection rate of TCD combined with CU in the diagnosis of CIS was 95.24%(120/126),which was higher than the 75.40%(95/126)of TCD and 66.67%(84/126)of CU(P<0.05).Conclusions TCD combined with CU,in the diagnosis of CIS,can assess plaque formation,intracranial vascular stenosis and stenosis degree,significantly improve the disease detection rate,and provide a reference for targeted clinical treatment.