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血管超声评估颈动脉粥样硬化斑块易损性的可行性研究 被引量:36
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作者 田小洁 惠品晶 +5 位作者 吕琦 颜燕红 丁亚芳 黄亚波 胡春洪 方琪 《中国脑血管病杂志》 CAS CSCD 北大核心 2020年第6期291-298,共8页
目的前瞻性研究血管超声评估颈动脉粥样硬化斑块易损性的可行性。方法连续纳入2019年3月至10月苏州大学附属第一医院神经外科行颈动脉内膜切除术(CEA)患者44例(46例次),术前常规行颈部血管超声(CDU)、CT血管成像、CT灌注成像和(或)DSA检... 目的前瞻性研究血管超声评估颈动脉粥样硬化斑块易损性的可行性。方法连续纳入2019年3月至10月苏州大学附属第一医院神经外科行颈动脉内膜切除术(CEA)患者44例(46例次),术前常规行颈部血管超声(CDU)、CT血管成像、CT灌注成像和(或)DSA检查,术后观察斑块大体形态并行组织病理苏木素-伊红(HE)及免疫组织化学CD31染色。设定斑块易损分数评分标准:依据CDU评估斑块形态、回声、纤维帽完整与否、有无溃疡、血管狭窄程度分别赋值以0~3分,计算责任斑块的易损分数,并以易损分数>4分为易损斑块,易损分数≤4分为稳定斑块;依据术后组织病理HE结果,将其分为易损组(36例次)和稳定组(10例次);根据术前6个月内是否发生缺血性卒中,将所有患者分为卒中患者33例(35例次)与非卒中患者11例(11例次);依据免疫组织化学CD31染色评估斑块内微血管密度。采用独立样本t检验、Wilcoxon秩和检验和χ2检验比较两组患者一般资料、实验室检查、临床表现、易损分数及易损斑块比率的差异;采用Kappa值评价CDU与组织病理HE评估斑块易损性的一致性。结果(1)一般临床资料:易损组与稳定组美国国立卫生研究院卒中量表评分、神经系统表现差异均有统计学意义(均P<0.05)。(2)易损分数:易损组明显高于稳定组[6.00(5.00,7.00)]分比4.00(4.00,4.25)分],差异有统计学意义(Z=-4.031,P<0.01);卒中患者易损分数明显高于非卒中患者[6.00(5.00,7.00)分比4.00(4.00,5.00)]分,差异有统计学意义(Z=-3.116,P=0.002)。(3)诊断效能:CDU易损分数判断易损斑块的敏感度为88.9%,特异度为8/10,阳性预测值为94.1%,阴性预测值为8/12,约登指数为68.9%,CDU与组织病理HE评估斑块易损性的一致性较强(Kappa=0.642,P<0.01)。(4)新生血管形成:免疫组织化学CD31染色见易损斑块内新生血管形成;易损组中微血管密度高于稳定组[(2.84±1.56)mm 2比(1.38±0.61)mm 2],差异有统计学意义(t=-4.507,P<0.01)。(5)易损斑块与缺血性卒中的关系:卒中患者中易损斑块比率高于非卒中患者[88.6%(31/35)比3/11;χ2=13.286,P<0.01]。结论运用血管超声判断斑块易损分数可准确、定量评估颈动脉斑块易损性,且易损斑块中可见新生血管形成,为临床诊断及精准治疗提供理论依据。 展开更多
关键词 颈动脉 超声 卒中 易损分数 新生血管
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Hazard and population vulnerability analysis: a step towards landslide risk assessment 被引量:2
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作者 Franny G.MURILLO-GARCíA Mauro ROSSI +2 位作者 Francesca ARDIZZONE Federica FIORUCCI Irasema ALCáNTARA-AYALA 《Journal of Mountain Science》 SCIE CSCD 2017年第7期1241-1261,共21页
In this paper, an attempt to analyse landslide hazard and vulnerability in the municipality of Pahuatlfin, Puebla, Mexico, is presented. In order to estimate landslide hazard, the susceptibility, magnitude (area-velo... In this paper, an attempt to analyse landslide hazard and vulnerability in the municipality of Pahuatlfin, Puebla, Mexico, is presented. In order to estimate landslide hazard, the susceptibility, magnitude (area-velocity ratio) and landslide frequency of the area of interest were produced based on information derived from a geomorphological landslide inventory; the latter was generated by using very high resolution satellite stereo pairs along with information derived from other sources (Google Earth, aerial photographs and historical information). Estimations of landslide susceptibility were determined by combining four statistical techniques: (i) logistic regression, (ii) quadratic discriminant analysis, (iii) linear discriminant analysis, and (iv) neuronal networks. A Digital Elevation Model (DEM) of lo m spatial resolution was used to extract the slope angle, aspect, curvature, elevation and relief. These factors, in addition to land cover, lithology anddistance to faults, were used as explanatory variables for the susceptibility models. Additionally, a Poisson model was used to estimate landslide temporal frequency, at the same time as landslide magnitude was obtained by using the relationship between landslide area and the velocity of movements. Then, due to the complexity of evaluating it, vulnerability of population was analysed by applying the Spatial Approach to Vulnerability Assessment (SAVE) model which considered levels of exposure, sensitivity and lack of resilience. Results were expressed on maps on which different spatial patterns of levels of landslide hazard and vulnerability were found for the inhabited areas. It is noteworthy that the lack of optimal methodologies to estimate and quantify vulnerability is more notorious than that of hazard assessments. Consequently, levels of uncertainty linked to landslide risk assessment remain a challenge to be addressed. 展开更多
关键词 LANDSLIDES SUSCEPTIBILITY HazardVulnerability RISK
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Proportioning Criteria for Traditional and Innovative Extrados Techniques for the Strengthening of Barrel Vaulted Structures Subjected to Rocking of the Abutments
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作者 Luca Ferrario Alessandra Marini +1 位作者 Paolo Riva Ezio Giuriani 《Journal of Civil Engineering and Architecture》 2010年第5期1-14,共14页
In this paper, the behavior of barrel-vaulted structures undergoing rocking of the abutments and the effectiveness of a few retrofit solutions are discussed. The comprehension of the structural performance of vault-ab... In this paper, the behavior of barrel-vaulted structures undergoing rocking of the abutments and the effectiveness of a few retrofit solutions are discussed. The comprehension of the structural performance of vault-abutment systems is fundamental for their seismic vulnerability assessment, and for the design of efficient strengthening techniques. In the paper, traditional techniques such as extrados thin concrete slab or masonry spandrel walls as well as an innovative solution with an extrados thin improved lime mortar slab reinforced by means of glass fiber mesh are considered. The different strengthening solutions are studied and compared on the basis of the results of non linear numerical analyses and by reference to a simplified analytical approach. Numerical and analytical models are validated through comparison with the results of a recent experimental study focusing on the behavior of vaulted masonry structures subjected to rocking of the abutments. The validated models can be used by engineers for the seismic vulnerability assessment of masonry vaulted structures as well as for the proportioning of possible extrados strengthening solutions, and will be used in the future to explore different structural system configurations. 展开更多
关键词 Abutment rocking vault abutment system extrados reinforcement.
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