摘要
目的:探讨彩色多普勒联合经颅多普勒(TCD)对颈动脉粥样硬化与脑梗死相关性的临床应用价值。方法:回顾性选取医院收治的初次住院且确诊为脑梗死的85例患者资料,将其纳入脑梗死组,另选84名同期健康体检者,将其纳入对照组,分别对两组行颈部彩色多普勒超声及TCD联合检查,比较两组颈部动脉狭窄情况、内膜中层厚度(IMT)和斑块形成情况以及颅内动脉狭窄情况。结果:脑梗死组与对照组相比颈动脉异常率显著升高,其中出现颈内动脉中度及重度狭窄率均显著升高、颈动脉闭塞患者率明显升高,其差异有统计学意义(x^2=16.687,x^2=8.298,x^2=4.048;P<0.01)。脑梗死组与对照组相比,右侧颈总动脉-IMT(RCCA-IMT)、右侧颈内动脉-IMT(RICA-IMT)、左侧颈总动脉-IMT(LCCA-IMT)和左侧颈内动脉-IMT(LICA-IMT)均显著增大,差异有统计学意义(t=2.107,t=2.204,t=2.227,t=2.700;P<0.01),且颈动脉IMT发生率及粥样硬化斑块发生率均显著升高,差异有统计学意义(x^2=16.684,x^2=21.346;P<0.01)。脑梗死组颅内动脉狭窄率高达91.76%,其中颅内动脉轻度、中度及重度的颅内动脉狭窄率均显著升高,差异有统计学意义(x^2=3.866,x^2=22.621,x^2=12.765;P<0.01)。脑梗死组颈部彩色多普勒超声及TCD联合检查示颈动脉斑块形成阳性率明显高于颅内动脉狭窄阳性率(x^2=2.306,P<0.05),而颈动脉斑块形成或颅内动脉狭窄阳性率明显高于颈动脉斑块形成阳性率,差异有统计学意义(x^2=12.25,P<0.05)。结论:颈部彩色多普勒超声及TCD联合检查能清楚的显示颈动脉粥样硬化及颅内动脉动力学改变情况,联合使用两种检测方法对预防和治疗脑梗死患者提供可靠依据。
Objective:To investigate the clinical value of color Doppler combined with transcranial Doppler(TCD)in the correlation study between carotid atherosclerosis and cerebral infarction.Methods:85 patients with cerebral infarction who were hospitalized at the first time were retrospectively selected in cerebral infarction group.And other 84 health individuals at the same time were divided into control group.All cases received combination examination of Color Doppler ultrasound and TCD.The incidence of cervical artery stenosis,intima-media thickening(IMT)and carotid artery plaque formation as well as intracranial arterial stenosis between the two groups were compared.Results:The abnormal rate of carotid artery in cerebral infarction group was significantly higher than that in the control group,and the incidences of moderate and severe carotid artery stenosis were significantly increased,and the incidence of carotid artery occlusion was also significantly increased(x2=16.687,x2=8.298,x2=4.048,P<0.01).And compared with the control group,the levels of RCCA-IMT,RICA-IMT,LCCA-IMT and LICA-IMT in the cerebral infarction group were significantly increased(t=2.107,t=2.204,t=2.227,t=2.700,P<0.01),and the incidences of carotid artery-IMT and atherosclerotic plaque in cerebral infarction group also were significantly increased(x2=16.684,x2=21.346,P<0.01).The incidence of intracranial artery stenosis in the cerebral infarction group was 91.76%,and the incidences of mild,moderate and severe intracranial artery stenosis in this group were significantly increased(x2=3.866,x2=22.621,x2=12.765,P<0.01).The results of cervical color Doppler ultrasound combined with TCD examination showed that the positive rate of carotid plaque formation was significantly higher than that of intracranial artery stenosis(x2=2.306,P<0.05),while the positive rate of carotid plaque formation or intracranial artery stenosis was significantly higher than that of carotid plaque formation(x2=12.25,P<0.05).Conclusion:Cervical color Doppler ultrasound combined with TCD examination can clearly show the dynamic changes of carotid atherosclerosis and intracranial artery,and the combined application of the two methods can provide a reliable basis in preventing and treating patients with cerebral infarction.
作者
王淑清
龚丽娜
颜明
WANG Shu-qing;GONG Li-na;YAN Ming(Department of Physical Diagnosis,Nanjing Central Hospital,Nanjing 210018,China)
出处
《中国医学装备》
2018年第12期85-89,共5页
China Medical Equipment
