CT血管成像评估颈动脉粥样硬化与远期卒中的临床研究

摘要

目的：探讨CT血管成像评估颈动脉粥样硬化与远期卒中的临床价值。方法选取颈动脉粥样硬化患者120例作为观察组，同期选择除外颈动脉粥样硬化的120例患者作为对照组，2组都进行CT血管成像评估、临床资料的调查与远期随访。结果观察组的颈动脉狭窄程度多为重度与闭塞，而对照组多为中度与轻度；观察组的颈动脉斑块类型多为易损斑块，而对照组多为稳定斑块，对比差异有统计学意义(P<0.05)。观察组与对照组随访6个月的卒中发生率分别为26.7%和5.0%，观察组明显高于对照组(P<0.05)；同时多因素Logistic回归分析，结果显示颈动脉狭窄程度(OR=3.327，95%CI：1.211～9.145)、颈动脉斑块形态(OR=3.699，95%CI：1.292～10.589)都为远期卒中的主要独立危险因素。结论 CT血管成像能有效评估颈动脉粥样硬化的狭窄程度与斑块形态，远期卒中的发生率也比较高，而狭窄程度与斑块形态与远期卒中密切相关，为此CT血管成像对判断预后具有重要的指导意义。%Objective To investigate the CT angiography assessment values for the carotid atherosclerosis and long-term stroke.Methods 120 carotid atherosclerosis patients wete selected as the observation group,and selected excepted carotid atherosclerosis 120 patients as the control group at the same periods,both groups were given the CT angiography assessment,surveyed clinical data and long-term followed-up.Results The degree of stenosis of the observation group with more severe to occlusion,while the control group were more with mild to moderate; the carotid artery plaque type in observation group were more vulnerable plaque,while the control group were more stable plaque,compared the difference in the two groups were statistically signiifcant (P<0.05).The followed six months of stroke rates in the observation group and the control group were 26.7% and 5.0% that the observation group were signiifcantly higher than the control group (P<0.05); multivariate Logistic regression analysis showed that degree of carotid stenosis (OR= 3.327,95%CI: 1.211-9.145),carotid plaque morphology (OR=3.699,95%CI: 1.292-10.589) were the independent risk factors for the long-term stroke.Conclusion CT angiography can effectively evaluate carotid atherosclerosis stenosis and plaque morphology,and the incidence of long-term stroke is relatively high,while the degree of stenosis and plaque morphology are closely related to the forward stroke,for which CT angiography for prognosis has important guiding signiifcances.