【摘要】：目的：分析頸內(nèi)動(dòng)脈系統(tǒng)AIS病人的頸動(dòng)脈粥樣硬化性斑塊的組分特征,并初步探討潰瘍斑塊、管腔狹窄程度、斑塊體積、低回聲斑塊組分、高回聲斑塊組分等斑塊組分特征之間的關(guān)系。 方法：收集于2008年1月-2014年1月期間連續(xù)收入我院治療的頸內(nèi)動(dòng)脈系統(tǒng)AIS病人病歷資料519例。根據(jù)高分辨率頸動(dòng)脈超聲檢查結(jié)果,將存在頸動(dòng)脈粥樣硬化斑塊的病人納入實(shí)驗(yàn),并統(tǒng)計(jì)頸動(dòng)脈斑塊的組分特征。如頸動(dòng)脈管腔狹窄程度、頸動(dòng)脈粥樣硬化斑塊體積、低回聲斑塊體積、高回聲斑塊體積,并利用邏輯回歸分析方法分析統(tǒng)計(jì)學(xué)方法分析斑塊組分特征。 結(jié)果：1、共有288例頸內(nèi)動(dòng)脈系統(tǒng)AIS病人檢出頸動(dòng)脈粥樣硬化性斑塊,其中49人檢出潰瘍斑塊。與無(wú)頸動(dòng)脈粥樣硬化潰瘍斑塊組相比,頸動(dòng)脈粥樣硬化潰瘍斑塊組病人的管腔狹窄程度、斑塊體積、低回聲斑塊組分體積、低回聲斑塊組分體積/斑塊總體積百分比更高(P0.05)。采用邏輯回歸分析方法分析,調(diào)整了年齡、性別和管腔狹窄程度等因素后,粥樣硬化性斑塊體積(OR值,1.11；95%CI,1.03-1.18)和低回聲斑塊體積/斑塊體積百分比(0R值,2.06；95%CI,1.53-3.19)與潰瘍斑塊呈正相關(guān),而高回聲斑塊體積/斑塊體積百分比與斑塊潰瘍呈負(fù)相關(guān)(OR值,0.63；95%CI,0.42-0.87)。 2、按頸動(dòng)脈狹窄程度將入組病人分為輕中度頸動(dòng)脈狹窄組(狹窄程度50%,n=162)和重度頸動(dòng)脈狹窄組(狹窄程度≥50%,n=126)。并分別對(duì)兩組病人中頸動(dòng)脈潰瘍斑塊與其它頸動(dòng)脈斑塊組分特征之間的關(guān)系行多因素分析：在輕中度狹窄病人中,低回聲斑塊體積/斑塊體積百分比與潰瘍斑塊呈正相關(guān)(0R值,3.14；95%CI,1.82-5.35),而高回聲斑塊體積/斑塊體積百分比與斑塊潰瘍呈負(fù)相關(guān)(OR值,0.41；95%CI,0.19-0.67)。 結(jié)論：高分辨率超聲檢測(cè)可以對(duì)頸動(dòng)脈粥樣硬化斑塊易損性、不穩(wěn)定性進(jìn)行評(píng)估,對(duì)AIS病人頸動(dòng)脈粥樣硬化斑塊的二級(jí)預(yù)防及危險(xiǎn)因素分層管理和治療具有指導(dǎo)意義。
[Abstract]:Objective: to analyze the component characteristics of carotid atherosclerotic plaques in patients with internal carotid artery system (AIS), and to explore the plaque size, plaque volume, and plaque components of ulcers, lumen stenosis, and hypoechoic plaques. The relationship between the characteristics of hyperechoic plaque components and other plaque components. Methods: from January 2008 to January 2014, 519 patients with AIS of internal carotid artery system who were admitted to our hospital from January 2008 to January 2014 were collected. According to the results of high resolution carotid ultrasound, the patients with carotid atherosclerotic plaques were included in the experiment, and the composition characteristics of carotid plaques were counted. For example, the degree of carotid lumen stenosis, carotid atherosclerotic plaque volume, hypoechoic plaque volume, hyperechoic plaque volume, and logical regression analysis were used to analyze the characteristics of plaque components. Results: 1. Carotid atherosclerotic plaques were detected in 288 patients with internal carotid artery system AIS, and ulcer plaques were detected in 49 of them. Compared with the group without carotid atherosclerosis ulcer plaque, the degree of lumen stenosis, plaque volume and hypoechoic plaque component volume in carotid atherosclerosis ulcer plaque group were significantly higher than those in carotid atherosclerosis ulcer plaque group. The percentage of hypoechoic plaque component volume / total plaque volume was higher (P 0.05). After adjusting the factors such as age, sex and lumen stenosis, the volume of atherosclerotic plaques (OR, 1.11) was analyzed by logical regression analysis. 95% CI, 1.03x1.18) and the percentage of low echo plaque volume / plaque volume (0R, 2.06); 95% CI1.53 鈮，

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