摘要
目的探讨彩色多普勒超声检测全前循环梗死(TACI)患者颈动脉硬化病变的诊断价值。方法选取2016年1月至2017年7月于榆林市第二医院超声诊断科进行检查的脑梗死患者110例,将40例TACI患者纳入TACI组,70例非TACI患者纳入非TACI组,另选取同期入院体检的健康志愿者40例为对照组,均行颈动脉超声检查,对比三组受检者的颈动脉有无斑块、斑块性质、内-中膜厚度(IMT)增厚率、管腔狭窄程度、斑块分布部位,并测定比较TACI组、非TACI组患者颈总动脉与颈内动脉血流动力学参数[收缩期最大峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)、搏动指数(PI)]。结果 TACI组患者的低/等回声斑块、混合回声斑块检出率分别为40.0%、45.0%,IMT增厚率和管腔中重度狭窄率分别为72.5%、35.0%,均明显高于非TACI组的21.4%、22.9%、52.9%、17.1%及对照组的5.0%、5.0%、32.5%、2.5%,非TACI组患者的上述指标也明显高于对照组,差异均有统计学意义(P<0.05);TACI组患者斑块分布位置为颈总动脉分叉处(BIF)的比率为42.5%,高于非TACI组的11.4%及对照组的2.5%,差异均有统计学意义(P<0.05);TACI组患者颈总动脉EDV和PSV分别为(72.1±13.2) cm/s、(23.6±4.7) cm/s,明显低于非TACI组的(84.2±15.2)cm/s、(29.3±4.2) cm/s,而颈内动脉PI和RI分别为(0.7±0.1)、(1.3±0.2),均明显高于非TACI组的(0.6±0.2)、(1.1±0.1),差异均有统计学意义(P<0.05)。结论彩色多普勒超声检测可较好地发现TACI患者颈动脉硬化病变,显示出斑块性质、发生部位及病变部位血流动力学变化,为疾病治疗赢得宝贵时间,值得在临床推广应用。
Objective To investigate the diagnostic value of color Doppler ultrasonography in detecting carotid atherosclerosis in patients with total anterior circulation infarction (TACI).Methods A total of 110 patients with cerebral infarction who were examined in the Department of Ultrasound Diagnosis at Yulin No.2 Hospital from January 2016 to July 2017 were selected in the study,of which 40 cases with TACI were included into the TACI group,70 cases without TACI were included into the non-TACI group.Besides,40 healthy volunteers who underwent physical examination in this hospital during the same period were enrolled in the control group.All subjects underwent carotid artery ultrasonography.The presence of plaque in carotid artery,plaque properties,the thickening rate of intima-media thickness (IMT),the degree of luminal stenosis,and plaque distribution were compared among the three groups.The hemodynamic parameters (maximal peak systolic velocity [PSV],end diastolic velocity [EDV],resistance index [RI],and pulsatility index [PI])of common carotid artery and internal carotid artery in the TACI group and non-TACI group were compared. Results The detection rates of low/equal echo plaques and mixed echo plaques in the TACI group were 40.0% and 45.0%,respectively.The IMT thickening rate and the moderate to severe luminal stenosis rate were 72.5% and 35.0%,respectively.All of the rates were higher than those in the non-TACI group (21.4%,22.9%,52.9%and 17.1%,respectively)and the control group (5.0%,5.0%,32.5% and 2.5%,respectively);the above indexes in the non-TACI group were also significantly higher than those in the control group;all differences were statistically significant (P<0.05).The proportion of plaques at carotid artery bifurcation (BIF)in the TACI group (42.5%)was higher than that in the non-TACI group (11.4%)and the control group (2.5%),P<0.05.The EDV and PSV of common carotid artery in the TACI group were (72.1±13.2)cm/s and (23.6±4.7)cm/s,respectively significantly lower than (84.2±15.2)cm/s,(29.3±4.2)cm/s in the non-TACI group,while the PI and RI of the internal carotid artery were (0.7±0.1)and (1.3±0.2),respectively significantly higher than (0.6±0.1)and (1.1±0.1)in the non-TACI group;all differences were statistically significant (P<0.05). Conclusion Color Doppler ultrasonography can better detect carotid atherosclerotic lesions in TACI patients,show plaque properties,occurrence sites and hemodynamics changes in the lesion position,and gain valuable time for disease treatment,which is worthy of clinical popularization and application.
作者
贺利霞
刘晓妮
HE Li-xia;LIU Xiao-ni(Department of Ultrasound Diagnosis,Yulin No.2 Hospital,Yulin 719000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2018年第24期3490-3493,共4页
Hainan Medical Journal
基金
陕西省卫生厅科研基金项目(编号:2012JM30579)
关键词
彩色多普勒超声
全前循环梗死
颈动脉硬化病变
血流动力学
诊断价值
Color Doppler ultrasonography
Total anterior circulation infarction
Carotid atherosclerosis
Hemodynamics
Diagnostic value
