颈动脉易损斑块风险模型的构建及与急性脑梗死患者认知障碍和预后的关系
作者:
作者单位:

(连云港市第一人民医院神经功能科,江苏省连云港市 222000)

作者简介:

周晓梅,硕士,主治医师,研究方向为神经电生理,E-mail:h49w584f231@126.com。通信作者周芯羽,副主任医师,硕士研究生导师,研究方向为神经病学,E-mail:zhouxinyu19820712@163.com。

基金项目:

江苏省人力资源和社会保障厅项目(2021K239B)


Construction of carotid vulnerable plaque risk model and its relationship with cognitive impairment and prognosis in patients with acute cerebral infarction
Author:
Affiliation:

Department of Neurology, Lianyungang First People's Hospital, Lianyungang, Jiangsu 222000, China)

  • 摘要
  • | |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • | |
    摘要:

    目的]研究颈动脉易损斑块与急性脑梗死(ACI)患者认知障碍和预后的关系。[方法]将2018年7月—2020年7月于连云港市第一人民医院诊断为ACI伴颈动脉易损斑块的患者180例作为观察组,另选取180例经健康体检诊断为不稳定斑块的研究人员作为对照组,分别对两组不稳定斑块积分比、斑块最大长度、斑块最大厚度、溃疡斑块、面积狭窄、狭窄处峰值流速以及阻力指数进行比较。[结果]两组患者的不稳定斑块积分比、斑块最大长度、斑块最大厚度、溃疡斑块、面积狭窄、狭窄处峰值流速以及阻力指数之间的差异存在统计学意义(P<0.05)。多因素分析显示,高不稳定斑块积分比、斑块最大长度、斑块最大厚度、溃疡斑块、面积狭窄处峰值流速以及阻力指数均是造成颈动脉易损斑块的危险因素。观察组患者的认知障碍(χ2=11.432,P=0.001)和预后不良(χ2=14.362,P=0.000)的发生率显著高于对照组。相关性分析显示,ACI患者的颈动脉易损斑块与认知障碍以及预后不良呈现显著的相关性。[结论]颈动脉易损斑块与ACI患者认知障碍和预后不良呈现显著的相关性,高不稳定斑块积分比、斑块最大长度、斑块最大厚度、溃疡斑块、面积狭窄、狭窄处峰值流速以及阻力指数均是造成颈动脉易损斑块的危险因素,建议对此类患者及时进行临床干预。

    Abstract:

    Aim To study the construction of carotid vulnerable plaque risk model and its relationship with cognitive impairment and prognosis in patients with acute cerebral infarction (ACI). Methods 180 patients with carotid vulnerable plaques in Lianyungang First People's Hospital from July 2018 to July 2020 were selected as observation group, and another 180 patients with unstable plaques who underwent physical examination were selected as control group. The unstable plaque integral ratio, the maximum length of plaques, the maximum thickness of plaques, ulcer plaques, area stenosis, peak flow velocity at stenosis and resistance index were compared to study the construction of carotid vulnerable plaque risk model and its relationship with cognitive impairment and prognosis in patients with ACI. Results There were significant differences between the two groups in unstable plaque integral ratio, maximum plaque length, maximum plaque thickness, ulcer plaque, area stenosis, peak flow velocity at stenosis and resistance index (P<0.05). Multivariate analysis showed that high unstable plaque integral ratio, maximum plaque length, maximum plaque thickness, ulcer plaque, peak flow velocity at area stenosis and resistance index were the risk factors for carotid vulnerable plaque. The incidence of cognitive impairment (χ2=11.432, P=0.001) and poor prognosis (χ2=14.362, P=0.000) in the observation group was significantly higher than those in the control group. Correlation analysis showed that carotid vulnerable plaques in ACI patients were significantly correlated with cognitive impairment and prognosis. Conclusions Carotid vulnerable plaque is significantly correlated with cognitive impairment and prognosis in patients with ACI. High unstable plaque integral ratio, maximum plaque length, maximum plaque thickness, ulcer plaque, area stenosis, peak flow velocity at stenosis and resistance index are all risk factors for carotid vulnerable plaque, it is suggested that clinical intervention should be carried out in time for such patients.

    参考文献
    [1] 齐炳才, 靳琦文, 胡杰, 等.颈动脉粥样硬化斑块内新生血管的研究现状及进展.中国动脉硬化杂志, 1,9(4):359-362.QI B C, JIN Q W, HU J, et al.Research status and progress of neovascularization in carotid atherosclerotic plaque.Chin J Arterioscler, 1,9(4):359-362.
    [2] JIANG C, ZHANG J, ZHU J, et al.Association between coexisting intracranial artery and extracranial carotid artery atherosclerotic diseases and ipsilateral cerebral infarction:a Chinese atherosclerosis risk evaluation (CARE-II) study.Stroke Vasc Neurol, 1,6(4):595-602.
    [3] ZHOU D, LI J, LIU D, et al.Irregular surface of carotid atherosclerotic plaque is associated with ischemic stroke:a magnetic resonance imaging study.J Geriatr Cardiol, 9,6(12):872-879.
    [4] LUO X H, LI W B, BAI Y, et al.Relation between carotid vulnerable plaques and peripheral leukocyte:a case-control study of comparison utilizing multi-parametric contrast-enhanced ultrasound.BMC Med Imaging, 9,9(1):74.
    [5] LIU F, WANG Z, CAO X, et al.Relationship between small dense low-density lipoprotein cholesterol with carotid plaque in Chinese individuals with abnormal carotid artery intima-media thickness.BMC Cardiovasc Disord, 1,1(1):216.
    [6] DUGGAL P, MEHAN S.Neuroprotective approach of anti-cancer microtubule stabilizers against tauopathy associated dementia:current status of clinical and preclinical findings.J Alzheimers Dis Rep, 9,3(1):179-218.
    [7] ZHOU X J, QI L Z.miR-124 is downregulated in serum of acute cerebral infarct patients and shows diagnostic and prognostic value.Clin Appl Thromb Hemost, 1,7:10760296211035446.
    [8] KONDO Y, KANZAKI M, ISHIMA D, et al.Cholesterol crystal embolism-related cerebral infarction:magnetic resonance imaging and clinical characteristics.eNeurologicalSci, 1,5:100388.
    [9] BAIDILDINOVA G, NAGY M, JURK K, et al.Soluble platelet release factors as biomarkers for cardiovascular disease.Front Cardiovasc Med, 1,8:684920.
    [10] YOSHIDA K, MIYAMOTO S, STUDY GROUP S K, et al.Stratification by multidimensional approach for rational treatment of asymptomatic carotid stenosis (SMART-K Study):study protocol.Neurol Med Chir, 0,0(1):10-16.
    [11] HORI S, HORI E, SHIBATA T, et al.Correlation between cerebral microbleeds and vulnerable plaque in patients with severe carotid artery stenosis:comparative magnetic resonance imaging study.J Stroke Cerebrovasc Dis, 9,8(10):104300.
    [12] SONG P G, FANG Z, WANG H Y, et al.Global and regional prevalence, burden, and risk factors for carotid atherosclerosis:a systematic review, Meta-analysis, and modelling study.Lancet Glob Health, 0,8(5):e721-e729.
    [13] LI X, LI J, WU G D.Relationship of neutrophil-to-lymphocyte ratio with carotid plaque vulnerability and occurrence of vulnerable carotid plaque in patients with acute ischemic stroke.Biomed Res Int, 1,1:6894623.
    [14] BOS D, ARSHI B, VAN DEN BOUWHUIJSEN Q J A, et al.Atherosclerotic carotid plaque composition and incident stroke and coronary events.J Am Coll Cardiol, 1,7(11):1426-1435.
    [15] IHLE-HANSEN H, IHLE-HANSEN H, SANDSET E C, et al.Subclinical carotid artery atherosclerosis and cognitive function:a mini-review.Front Neurol, 1,2:705043.
    [16] 高晓, 冯莹印, 纪盛章.不同年龄患者颈动脉斑块的高分辨磁共振研究.中国实用神经疾病杂志, 1,4(23):2025-2034.GAO X, FENG Y Y, JI S Z.High resolution magnetic resonance imaging of carotid plaque in patients of different ages.Chin J Practical Neurod, 1,4(23):2025-2034.
    [17] LARSSON AC, ROSFORS S.Diameter-based measurements of the degree of carotid artery stenosis using ultrasonography.Clin Physiol Funct Imaging, 1,1(2):217-220.
    [18] ABEDI V, RAZAVI S M, KHAN A, et al.Artificial intelligence:a shifting paradigm in cardio-cerebrovascular medicine.J Clin Med, 1,0(23):5710.
    [19] 余浩佳, 王赛男, 陈星弛, 等.HR-MRI血管壁成像技术联合血清ox-LDL、Lp-PLA2水平对大脑中动脉粥样硬化性狭窄患者预后的评估价值.中国动脉硬化杂志, 1,9(5):423-427.YU H J, WANG S N, CHEN X C, et al.The prognostic value of HR-MRI angiography combined with serum ox-LDL and Lp-PLA2 levels in patients with middle cerebral artery atherosclerotic stenosis.Chin J Arterioscler, 1,9(5):423-427.
    [20] PERVIN Z, STEPHEN J M.Effect of alcohol on the central nervous system to develop neurological disorder:pathophysiological and lifestyle modulation can be potential therapeutic options for alcohol-induced neurotoxication.AIMS Neurosci, 1,8(3):390-413.
    [21] CONTE M S, BRADBURY A W, KOLH P, et al.Global vascular guidelines on the management of chronic limb-threatening ischemia .Eur J Vasc Endovasc Surg, 9,8(1S):S1-S109.
    [22] 许莉莉, 丁素玲, 张伟伟, 等.STAT4基因敲除通过miR-9促进泡沫细胞形成及动脉粥样硬化.中国动脉硬化杂志, 0,8(5):410-420.XU L L, DING S L, ZHANG W W, et al.STAT4 knockdown promotes foam cell formation and atherosclerosis through miR-9.Chin J Arterioscler, 0,8(5):410-420.
    引证文献
引用本文

周晓梅,任孝林,周芯羽.颈动脉易损斑块风险模型的构建及与急性脑梗死患者认知障碍和预后的关系[J].中国动脉硬化杂志,2022,30(7):606~610.

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
历史
  • 收稿日期:2022-04-14
  • 最后修改日期:2022-05-15
  • 在线发布日期: 2022-07-11