颈动脉超声在分析影响缺血性脑血管病变严重程度的危险因素中的应用
| 作者: |
1郭莹
1 辽阳市中心医院彩超室，辽宁 辽阳 111000 |
| 通讯: |
郭莹
Email: guoyingyg@yeah.net |
| DOI: | 10.3978/j.issn.2095-6959.2015.06.030 |
摘要
目的：通过颈动脉超声检测探究正常人与缺血性脑血管病变(ischemic cerebral vascular disease，ICVD)颈动脉轻度狭窄、中度狭窄、重度狭窄患者血流动力学参数、动脉粥样硬化斑块分型、指数、积分以及颈内和颈总动脉内膜中层厚度和血流速度增长百分比等指标，分析导致ICVD加重的危险因素，为临床上诊断ICVD及其严重程度提供有力的技术支持。方法：采用病例对照研究方法，应用Beckman全自动生化分析仪检测各组研究对象总胆固醇(total cholesterol，TC)、三酰甘油(triglyceride，TG)、低密度脂蛋白(low density lipoprotein，LDL)、高密度脂蛋白水平(high-density lipoprotein deficiency，HDL)；采用颈动脉超声仪检测各组对象颈动脉血管内径(vessel diameter，VD)、平均血流速度(mean flow velocity，MFV)、舒张末期最低血流速度(end-diastole velocity，EDV)、收缩期最大血流速度(peak systohcvelocity，PSV)、颈总动脉和颈内动脉内膜中层厚度(intima-media thickness，IMT)；分析计算各组对象动脉粥样硬化指数(atherosclerosis index，AI)、斑块积分以及血流速度增长百分比；采用SPSS运用logistic回归模型分析影响ICVD变严重程度的危险因素。结果：ICVD颈动脉轻度狭窄、中度狭窄、重度狭窄患者TC、TG、LDL明显高于正常对照组，HDL低于正常对照组，ICVD三个组别之间TC、TG、LDL、HDL均有统计学差异(P<0.05)；ICVD组别与正常对照组相比，VD、MFV、EDV、PSV明显升高，但四组间无明显统计学差异(P>0.05)；ICVD患者动脉粥样硬化的发生部位主要是颈总动脉，并以软斑为主；ICVD组别与正常对照组相比，AI、斑块积分、颈总动脉和颈内动脉IMT明显增加，且ICVD组别之间AI、斑块积分、颈总动脉和颈内动脉IMT也有明显差异(P<0.05)；ICVD组别与正常对照组相比，屏气前后血流速度增长百分比明显下降，且ICVD组别之间血流增长速度百分比也有明显差异(P<0.05)；影响ICVD严重程度的危险因素主要包括AI、颈总动脉和颈内动脉IMT、颈总动脉和颈内动脉血流增长速度百分比、斑块积分、软斑。结论：应用颈动脉超声分析影响ICVD严重程度的危险因素，有助于早诊断和防止ICVD的病情恶化，提高患者的生命质量。
关键词：
缺血性脑血管病变
颈动脉狭窄
动脉粥样硬化
斑块
颈动脉内膜中层厚度
颈动脉血流速度增长百分比
危险因素
Application of carotid ultrasound on the analysis of the risk factors for the severity of ischemic cerebrovascular disease
CorrespondingAuthor: GUO Ying Email: guoyingyg@yeah.net
DOI: 10.3978/j.issn.2095-6959.2015.06.030
Abstract
Objective: To explore the indexes such as hemodynamic parameters, atherosclerotic plaque classification, index, integration, common carotid and internal carotid intima-media thickness and blood flow velocity growth percentage of normal people and ischemic cerebrovascular disease patients with mild stenosis, moderate stenosis, severe stenosis with carotid ultrasound, analyze the risk factors for the aggravating of ICVD and provide technical support for diagnosis of ICVD severity. Methods: We carried the study by matched case-control study; Beckman automatic biochemical analyzer was used to detect the TC, TG, HDL, LDL of the subjects in the four groups; carotid ultrasound was used to detect the VD, MFV, EDV, PSV, IMT of the subjects in the four groups; atherosclerotic index, integration and blood flow velocity growth percentage were analyzed and calculated; Logistic regression model was used to analyze the risk factors for the aggravating of ICVD. Results: The level of TC, TG, LDL were increased and the HDL were decreased in the ischemic cerebrovascular disease with mild stenosis, moderate stenosis, severe stenosis groups when compared with the normal group. There were statistically significant differences in TC, TG, HDL, LDL among four groups of ICVD (P<0.05); There were no statistically significant differences in between VD, MFV, EDV, PSV between normal group and ICVD groups (P>0.05); The occurrence of atherosclerosis parts in ischemic cerebrovascular disease patients were mainly common carotid arterys, and given priority to soft spots; atherosclerotic index, integration, common carotid and internal carotid IMT were increased and blood flow velocity growth percentage were decreased in the ICVD groups when compared with the normal group (P<0.05). There were statistically significant differences in atherosclerotic index, integration, common carotid and internal carotid IMT, blood flow velocity growth percentage among three groups of ICVD (P<0.05); The risk factors for the aggravating of ICVD include AI, common carotid and internal carotid IMT, common carotid and internal carotid blood flow velocity growth percentage, atherosclerotic integration and soft spots. Conclusion: Application of carotid ultrasound on the analysis of the risk factors for the severity of ischemic cerebrovascular disease can help to early diagnosis and prevent the deterioration of ischemic cerebrovascular disease, so that improving the life quality of patients.