[1]师 媛,王晓娟.短暂性脑缺血发作患者颈动脉狭窄程度与颈动脉斑块易损性关系及对近期缺血性脑卒中的预测价值研究[J].陕西医学杂志,2022,51(4):454-457,496.[doi:DOI:10.3969/j.issn.1000-7377.2022.04.016]
 SHI Yuan,WANG Xiaojuan.Relationship between degree of carotid artery stenosis and vulnerability to carotid plaque in patients with transient ischemic attack and its predictive value for recent ischemic stroke[J].,2022,51(4):454-457,496.[doi:DOI:10.3969/j.issn.1000-7377.2022.04.016]
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短暂性脑缺血发作患者颈动脉狭窄程度与颈动脉斑块易损性关系及对近期缺血性脑卒中的预测价值研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年4期
页码:
454-457,496
栏目:
临床研究
出版日期:
2022-04-05

文章信息/Info

Title:
Relationship between degree of carotid artery stenosis and vulnerability to carotid plaque in patients with transient ischemic attack and its predictive value for recent ischemic stroke
作者:
师 媛1王晓娟2
(1.延安大学附属医院神经内科,陕西 延安 716000; 2.宝鸡市中医医院脑病二科, 陕西 宝鸡 721000)
Author(s):
SHI YuanWANG Xiaojuan
(Department of Neurology,Affiliated Hospital of Yan'an University,Yan'an 716000,China)
关键词:
短暂性脑缺血 颈动脉狭窄 超声 颈动脉斑块易损性 磁共振特征 缺血性脑卒中
Keywords:
Transient cerebral ischemia Carotid artery stenosis Ultrasound Vulnerability of carotid plaque Magnetic resonance characteristics Ischemic stroke
分类号:
R 743
DOI:
DOI:10.3969/j.issn.1000-7377.2022.04.016
文献标志码:
A
摘要:
目的:分析短暂性脑缺血发作患者颈动脉狭窄程度与颈动脉斑块易损性的关系及对早期脑卒中的预测价值。方法:选取206例短暂性脑缺血发作患者作为研究对象,均进行颈动脉超声检查,明确颈动脉狭窄程度,分为明显狭窄组(狭窄率≥30%)和非明显狭窄组(狭窄率<30%); 所有患者均接受高分辨磁共振斑块成像检查,定量分析责任侧颈动脉粥样硬化斑块病变参数,使用Pearson相关性分析颈动脉狭窄程度与斑块相关特征的关系; 随访12个月,观察缺血性脑卒中发生情况,通过受试者工作特征曲线(ROC)下面积(AUC)评价颈动脉狭窄程度对缺血性脑卒中的预测效能。结果:明显狭窄组与非明显狭窄组的责任侧颈动脉粥样硬化斑块病变参数比较,差异有统计学意义(均P<0.05); 经Peason相关性分析,短暂性脑缺血发作患者颈动脉狭窄程度与最大管壁厚度(maxWT)和富脂质核(LRNC)%均呈正相关(r=0.642、0.718,均P=0.000); 所有患者均获得随访12个月,发生缺血性脑卒中42例,占20.39%。经ROC曲线分析,颈动脉狭窄程度预测短暂性脑缺血发作患者发生缺血性脑卒中的AUC为0.869。结论:短暂性脑缺血发作患者颈动脉狭窄程度与斑块易损性呈正相关,预测近期缺血性脑卒中发生的效能较好,值得临床予以重视应用。
Abstract:
Objective:To analyze the relationship between carotid artery stenosis degree and vulnerability to carotid plaque in patients with transient ischemic attack and its predictive value for recent ischemic stroke.Methods:206 patients with transient ischemic attack were selected as the subjects.All patients underwent carotid artery ultrasound examination to determine the degree of carotid artery stenosis,and were divided into obvious stenosis group(stenosis rate≥30%)and non-obvious stenosis group(stenosis rate<30%).All patients received high resolution magnetic resonance plaque imaging,and the lesion parameters of carotid atherosclerotic plaque on the responsible side were quantitatively analyzed.Pearson correlation analysis was used to analyze the relationship between the degree of carotid artery stenosis and plaque related characteristics.After 12 months of follow-up,the incidence of ischemic stroke was observed,and the area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the predictive efficiency of carotid artery stenosis on ischemic stroke.Results:There were statistically significant differences in the lesion parameters of carotid atherosclerotic plaque on the responsible side between the obvious stenosis group and the non-obvious stenosis group(all P<0.05).Through Peason correlation analysis,the degree of carotid stenosis was positively correlated with maxWT and LRNC%(r=0.642,0.718,all P=0.000).All patients were followed up for 12 months,and 42 patients(20.39%)had ischemic stroke.According to ROC curve analysis,the AUC of degree of carotid stenosis in predicting ischemic stroke in patients with transient ischemic attack was 0.869.Conclusion:The degree of carotid stenosis in patients with transient ischemic attack is positively correlated with plaque vulnerability,which is effective in predicting the occurrence of recent ischemic stroke and deserves clinical attention.

参考文献/References:

[1] 王明玉,杨 茹,何明利,等.丁苯酞序贯疗法联合奥扎格雷钠治疗短暂性脑缺血发作患者的临床研究[J].中国临床药理学杂志,2019,35(20):2531-2534.
[2] 孟军鹏,孟 林.颈动脉支架植入术对症状性颈动脉狭窄患者血清炎症因子及认知功能影响的临床研究[J].陕西医学杂志,2020,49(7):796-799.
[3] 费云瀚,刘 斌,董亚楠,等.血管生成相关分子标记物与急性脑梗死患者颈动脉颅外段狭窄相关性研究[J].陕西医学杂志,2019,48(4):427-431.
[4] Itoh H,Kaneko H,Kiriyama H,et al.Relation between the updated blood pressure classification according to the ACC/AHA guidelines and carotid intima-media thickness[J].The American Journal of Cardiology,2019,124(3):396-401.
[5] 吕颖顺,叶小汉,王 婷.动脉粥样硬化患者不同中医证型间颈动脉超声影像对比[J].陕西中医,2018,39(4):455-457.
[6] Cheng SF,Zarkali A,Richards T,et al.Carotid artery stenosis,an underestimated cause of stroke recurrence in patients with ischaemic monocular visual loss[J].Annals of The Royal College of Surgeons of England,2019,101(8):1-5.
[7] Lindenholz A,Kolk A,Schaaf I,et al.Intracranial atherosclerosis assessed with 7-T MRI:Evaluation of patients with ischemic stroke or transient ischemic attack[J].Radiology,2020,295(1):190643.
[8] 张 莹,康 黎,刘运安,等.短暂性脑缺血发作患者血流动力学及血压变异性与颈动脉狭窄严重程度的相关性研究[J].实用临床医药杂志,2020,24(5):7.
[9] 丁 蓓,江 泓,张 欢,等.颈动脉系统短暂性脑缺血发作患者FLAIR序列高信号血管征与CT灌注成像的对照研究[J].临床放射学杂志,2019,38(6):964-968.
[10] Zhang L,Zhu L,Lu M,et al.Comparison of carotid plaque characteristics between men and women using magnetic resonance vessel wall imaging:A chinese atherosclerosis risk evaluation study[J].Journal of Magnetic Resonance Imaging,2021,54(2):646-654.
[11] 杨 芳,张佳星,任 歆,等.缺血性脑卒中和非脑卒中病人颈动脉内中膜厚度与狭窄程度的关系[J].中西医结合心脑血管病杂志,2020,18(19):3.
[12] Murata K,Murata N,Chu B,et al.Characterization of carotid atherosclerotic plaques using 3-dimensional MERGE magnetic resonance imaging and correlation with stroke risk factors[J].Stroke,2020,51(2):475-480.
[13] Xiao J,Patrick MM,Jiang T,et al.Acute ischemic stroke versus transient ischemic attack:Differential plaque morphological features in symptomatic intracranial atherosclerotic lesions[J].Atherosclerosis,2021,2(319):72-78.
[14] Madsen TE,Khoury JC,Alwell K,et al.Temporal trends of sex differences in transient ischemic attack incidence within a population[J].Journal of Stroke and Cerebrovascular Diseases,2019,28(9):2468-2474.
[15] 孔娅娜,赵永娜,李恩静,等.新型颈动脉狭窄预测模型在短暂性脑缺血发作患者中的应用[J].中华老年心脑血管病杂志,2020,22(5):510-513.
[16] Kim S,Kwak HS,Chung GH.Carotid intraplaque hemorrhage in patients with greater than fifty percent carotid stenosis was associated an acute focal cerebral infarction[J].Neurology Asia,2018,23(3):209-216.
[17] Tallarita T,Sorenson TJ,Rinaldo L,et al.Management of carotid artery stenosis in patients with coexistent unruptured intracranial aneurysms[J].Journal of Vascular Surgery,2019,69(6):2001.
[18] 冯千伟,吴小坤,刘 斌,等.短暂性脑缺血发作患者血压变异性与颅外段颈动脉狭窄及狭窄程度的相关性[J].中华老年心脑血管病杂志,2018,20(8):58-61.
[19] 李振强,马明辉,郭子琪.头颅CT血管造影联合磁共振血管造影对短暂性脑缺血发作后卒中的预测价值[J].实用临床医药杂志,2020,24(6):30-33.
[20] 刘新生,张瑞锋,冯丽君,等.短暂性脑缺血发作病人血清尿酸及胱抑素C水平与颈内动脉狭窄的关系[J].中西医结合心脑血管病杂志,2020,18(2):331-333.

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备注/Memo

备注/Memo:
基金项目:陕西省教育厅专项科研计划项目(19JK0972)
更新日期/Last Update: 2022-04-07