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颈动脉内膜中层厚度和脑动脉血流动力学指标对冠心病患者并发缺血性脑卒中的预测价值

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摘要:

目的 分析颈动脉内膜中层厚度和脑动脉血流动力学指标对冠状动脉粥样硬化性心脏病(冠心病)患者并发缺血性脑卒中的预测价值。方法 选择2016年8月至2020年11月于广东省信宜市中医院接受治疗的冠心病患者87例。依据患者是否并发缺血性脑卒中分组,其中对照组52例(未并发缺血性脑卒中),病例组35例(并发缺血性脑卒中)。对比两组患者的一般临床资料、脑动脉血流动力学指标。分析冠心病患者并发缺血性脑卒中的影响因素,并预测各独立影响因素对冠心病患者并发缺血性脑卒中的价值。结果 病例组的收缩压(OR=1.042,95%CI:0.138~7.860,P=0.968)舒张压(OR=1.039,95%CI:0.730~1.478,P=0.833)颈动脉内膜中层厚度(OR=4.707,95%CI:1.139~19.454,P=0.032)和平均血流速度(Vm,OR=3.353,95%CI:1.251~8.988,P=0.016)、搏动指数(PI,OR=10.074,95%CI:1.535~66.129,P=0.016)和阻力指数(RI,OR=8.020,95%CI:1.065~60.389,P=0.043)均高于对照组(P<0.05)。Vm、PI、RI和颈动脉内膜中层厚度为冠心病患者并发缺血性脑卒中的独立影响因素(P<0.05),上述指标ROC曲线面积分别为0.856、0.807、0.700、0.858 。结论 颈动脉内膜中层厚度和脑动脉血流动力学指标是影响冠心病并发缺血性脑卒中的危险因素,且在评估冠心病并发缺血性脑卒中方面具有较高的预测价值。

Abstract:

Objective To analyze the predictive value of indexes of carotid artery intima-media thickness (CA-IMT) and cerebral artery hemodynamic indexes to complicated ischemic stroke in patients with coronary heart disease (CHD). Methods CHD patients (n=87) were chosen from Hospital of Traditional Chinese Medicine of Xinyi City of Guangdong Province from Aug. 2016 to Nov. 2020. All patients were divided, according to whether or not they had complicated ischemic stroke, into control group (n=52) and case group (n=35). The general clinical materials and hemodynamic indexes were compared between 2 groups. The influence factors of CHD complicated by ischemic stroke were analyzed, and the value of different independent influence factors to CHD complicated by ischemic stroke was predicted. Results In case group, systolic blood pressure (SBP, OR=1.042, 95%CI: 0.138~0.860, P=0.968), diastolic blood pressure (DBP, OR=1.039, 95%CI: 0.730~1.478, P=0.833), CA-IMT (OR=4.707, 95%CI: 1.139~19.454, P=0.032), mean flow velocity (Vm, OR=3.353, 95%CI: 1.251~8.988, P=0.016), pulse index (PI, OR=10.074, 95%CI: 1.535~66.129, P=0.016) and resistance index (RI, OR=8.020, 95%CI: 1.065~60.389, P=0.043) were all higher than those in control group (P<0.05). Vm, PI, RI and CA-IMT were independent influence factors of CHD complicated by ischemic stroke (P<0.05), and AUC of ROC curve of above indexes was, respectively, 0.856, 0.807, 0.700 and 0.858. Conclusion CA-IMT and cerebral artery hemodynamic indexes are risk factors affecting CHD complicated by ischemic stroke, and they have higher predictive value to review of CHD complicated by ischemic stroke.

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  • 2008

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