标题：超声评价颈总动脉内-中膜厚度、斑块性质对预测脑梗死发生的价值

      作者：何伟明，支春妹，李少君    湛江市第二中医医院超声科，广东 湛江 524013

      卷次： 2019年30卷11期

      【摘要】 目的 探讨超声评价颈总动脉内-中膜厚度(IMT)、粥样硬化斑块(CAS)性质对预测脑梗死发生的应用价值。方法 选择2016年10月至2018年11月期间在湛江市第二中医医院超声科行颈动脉检查的患者100例，其中以50例确诊脑梗死患者为观察组，50例确诊非脑梗死患者为对照组，比较两组患者的 IMT及斑块性质。结果 观察组患者的 IMT增厚率为90.0%，明显高于对照组的58.0%，IMT厚度为(1.25±0.21) mm，积分为(2.61±0.4)分，均明显大于对照组的(0.63±0.09) mm、(1.22±0.3)分，差异均具有统计学意义(P<0.05)；观察组患者的斑块总数为78个，明显多于对照组的 42个，软斑发生率为 59.0%、混合斑发生率为 19.2%，均明显高于对照组的 38.1%和 2.4%，硬斑发生率为20.5%，明显低于对照组的59.5%，以上各项指标比较差异均具有统计学意义(P<0.05)；观察组患者的斑块厚度为(3.02±0.23) mm、面积为(0.49±0.14) cm2、血管狭窄率为(68.3±11.2)%，均明显大于或高于对照组的(2.01±0.12) mm、(0.30±0.04) cm2、(44.1±9.1)%，差异均有统计学意义(P<0.05)，差异均具有统计学意义。结论 IMT、CAS与脑梗死的发病密切相关，颈动脉超声检查具有安全无创、快速简便、重复性好、价格低廉等优点，对脑梗死的预测具有重要临床价值。
      【关键词】 超声；颈总动脉；内-中膜厚度；斑块性质；脑梗死
      【中图分类号】 R743.33 【文献标识码】 A 【文章编号】 1003—6350（2019）11—1422—04

Ultrasound evaluation of the intima-media thickness and plaque properties of the common carotid artery inpredicting the onset of cerebral infarction.
HE Wei-ming, ZHI Chun-mei, LI Shao-jun. Department of Ultrasound,Zhanjiang Second Hospital of Traditional Chinese Medicine, Zhanjiang 524013, Guangdong, CHINA
【Abstract】 Objective To discuss the application value of ultrasound evaluation of intima-media thickness(IMT) and atherosclerosis (CAS) properties of the common carotid artery in predicting the onset of cerebral infarction.Methods A total of 100 patients were selected, who accepted carotid artery ultrasonography in the Department of Ultra-sound at Zhanjiang Second Hospital of TCM during October 2016 and November 2018. Among them, 50 patients diag-nosed as cerebral infarction were in the observation group, and 50 patients diagnosed as non-cerebral infarction were in thecontrol group. The IMT and plaque properties were compared between the two groups. Results In the observation group,the IMT thickening rate was 90.0%, which was significantly higher than 58.0% in the control group; the IMT thick-ness was (1.25±0.21) mm and the score was (2.61±0.4) points, which was significantly higher than corresponding (0.63±0.09) mm and (1.22±0.3) points in the control group (P<0.05 for all comparisons). In the observation group, the total num-ber of plaques was 78, significantly more than 42 in the control group; the incidence of soft plaque and mixed plaque wasrespectively 59.0% and 19.2%, which were significantly higher than corresponding 38.1% and 2.4% in the control group;but the hard plaque rate was 20.5%, which was significantly lower than 59.5% in the control group; all differences inthe above indicators were statistically significant (P<0.05). In the observation group, the plaque thickness was (3.02±0.23) mm, the area was (0.49±0.14) cm2, and the stenosis rate was (68.3±11.2)%, which was significantly greater or higherthan corresponding (2.01±0.12) mm, (0.30±0.04) cm2, and (44.1±9.1)% in the control group (P<0.05). Conclusion IMTand CAS are closely related to the onset of cerebral infarction. Carotid artery ultrasonography is safe, non-invasive,quick and easy, reproducible, and inexpensive. It has important clinical value in the prediction of cerebral infarction.
      【Key words】 Ultrasound; Common carotid artery; Intima-media thickness; Plaque properties; Cerebral infarction