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目的通过超声检测探讨急性脑梗死(ACI)患者颈动脉及椎动脉结构和血流动力学特征。方法对298例ACI患者及101例健康对照者行颈动脉及椎动脉超声检测,分析两组间血管内径、内膜中膜厚度(IMT)、血管阻力指数(RI)及血流速度等方面的差异。根据NIHSS评分,把ACI组分为2个亚组:进展性ACI组和非进展性ACI组,比较2个亚组间上述超声参数的差异。结果 (1)ACI组颈总动脉内径、颈内动脉内径、颈总动脉RI、左侧颈内动脉RI均大于健康对照组(P<0.05);ACI组颈总动脉舒张末期血流速度(Vd)、颈内动脉收缩期峰值血流速度(Vs)、颈内动脉Vd、右侧椎动脉Vs及Vd均低于健康对照组(P<0.05)。(2)进展性ACI组左侧颈总动脉Vs、左侧颈总动脉RI、颈内动脉IMT高于非进展性ACI组(P<0.05);进展性ACI组右侧椎动脉Vs低于非进展性ACI组(P<0.05)。(3)Pearson相关性分析表明,年龄与各血管超声参数相关。结论颈动脉粥样硬化血管结构失代偿是ACI的特征之一,颈内动脉IMT增厚可能是ACI进展加重的危险信号。
Objective To investigate the structural and hemodynamic characteristics of carotid artery and vertebral artery in patients with acute cerebral infarction (ACI) by means of ultrasound. Methods The carotid artery and vertebral artery were examined by ultrasound in 298 ACI patients and 101 healthy controls. The vascular diameter, intima - media thickness (IMT), vascular resistance index (RI) and blood flow velocity difference. According to the NIHSS score, the ACI groups were divided into two subgroups: progressive ACI group and non-progressive ACI group, and the difference of ultrasonic parameters between the two subgroups was compared. Results (1) The diameter of common carotid artery, the diameter of internal carotid artery, the RI of common carotid artery and the RI of left internal carotid artery in ACI group were significantly higher than those in healthy control group (P <0.05). In ACI group, the end diastolic blood flow velocity ), Peak systolic blood flow velocity (Vs), internal carotid artery Vd, right vertebral artery Vs and Vd were lower than those in healthy control group (P <0.05). (2) Vs, carotid artery left common carotid artery and carotid artery IMT were significantly higher in progressive ACI group than those in non-progressive ACI group (P <0.05); Vs of right vertebral artery in progressive ACI group were lower than non-progressive ACI group Progressive ACI group (P <0.05). (3) Pearson correlation analysis showed that age was related to the parameters of each vessel ultrasound. Conclusions The decompensation of carotid atherosclerosis is one of the characteristics of ACI. Thickening of IMT may be a dangerous signal for the worsening of ACI.