彩色多普勒超声血流参数、血清尿酸、胱抑素C对短暂性脑缺血发作患者颈动脉狭窄的诊断价值OACSTPCD
Diagnostic value of blood flow parameters,serum uric acid and CysC by color Doppler ultrasound in carotid artery stenosis of transient ischemic attack
目的 分析彩色多普勒超声(TCD)血流参数、血清尿酸、胱抑素C(CysC)对短暂性脑缺血发作(TIA)患者颈动脉狭窄的诊断价值.方法 前瞻性选取2020年1月至2022年9月于陆军第八十二集团军医院超声诊断科进行诊疗的T1A患者126例为研究对象,以数字减影血管造影结果为金标准,根据颈动脉狭窄程度将患者分为正常组(32例)、轻度组(50例)以及中-重度组(44例),比较3组患者TCD血流参数、血清尿酸及CysC差异.Logistic回归分析影响TIA患者颈动脉狭窄的危险因素,建立受试者工作特征(ROC)曲线评价TCD血流参数、血清尿酸及CysC对TIA患者颈动脉狭窄的诊断及鉴别价值.结果 3组患者的收缩期峰值流速(PSV)、舒张末期流速(EDV)、平均流速(MFV)、尿酸、CysC水平比较,中-重度组＞轻度组＞正常组,差异有统计学意义(P＜0.05).二元Logistic回归分析显示糖尿病、PSV、尿酸、CysC是TIA患者颈动脉狭窄的独立危险因素(P＜0.05).ROC曲线结果显示,PSV、尿酸、CysC单独诊断及联合诊断T1A患者颈动脉狭窄的曲线下面积(AUC)为0.964、0.814、0.810、0.971.PSV、尿酸、CysC单独鉴别及联合鉴别TIA患者颈动脉狭窄程度 AUC 为 0.808、0.692、0.666、0.815.结论 TIA 颈动脉狭窄患者PSV、EDV、MFV值、尿酸、CysC水平均有异常升高,且狭窄程度越重升高越明显,PSV、尿酸、CysC联合时对临床诊断、鉴别TIA患者颈动脉狭窄情况有一定参考价值.
Objective To analyze the diagnostic value of color Doppler ultrasound blood flow parameters,serum uric acid and cystatin C(CysC)for carotid stenosis in patients with transient ischemic attack(TIA).Methods A total of 126 TIA patients were prospectively selected from January 2020 to September 2022 in Ultrasound Diagnostic Department of the 82nd Group Military Hospital of PLA.They were divided into a normal group(32 patients),a mild group(50 patients),and a moderate and severe group(44 patients)according to the degree of carotid stenosis.TCD blood flow parameters,serum uric acid,and CysC levels were compared among three groups.The binary Logistic regression was used to analyze the factors affecting carotid artery stenosis in TIA patients,and the receiver operating characteristic(ROC)curve was established to evaluate the value of color Doppler ultrasound blood flow parameters,serum uric acid and CysC in diagnosing carotid artery stenosis in TIA patients individually and jointly,and in differentiating the degree of stenosis.Results The peak systolic flow velocity(PSV),end diastolic flow velocity(EDV),mean flow velocity(MFV),uric acid and CysC levels of patients in the moderate and severe groups were significantly higher than those in the mild group and the normal group(P＜0.05).Binary Logistic regression analysis showed that diabetes,PSV,uric acid and CysC were independent risk factors for carotid stenosis in TIA patients(P＜0.05).The ROC curve results showed that the area under the curve(AUC)of carotid artery stenosis in TIA patients diagnosed by PSV,uric acid and CysC respectively and jointly was 0.964,0.814,0.810 and 0.971.The AUC of carotid artery stenosis degree in TIA patients was 0.808,0.692,0.666 and 0.815 respectively and jointly identified by PSV,uric acid and CysC.Conclusion The PSV,EDV,MFV,uric acid and CysC levels of TIA patients with carotid stenosis were abnormally increased,and the higher the severity of stenosis was,the more obvious the increase was.The combination of PSV,uric acid and CysC has certain reference value for clinical diagnosis and differential diagnosis of carotid stenosis in TIA patients.
何彬;王静
071000 河北保定,陆军第八十二集团军医院超声诊断科071000 河北保定,陆军第八十二集团军医院超声诊断科
短暂性脑缺血发作颈动脉狭窄彩色多普勒超声血流参数尿酸胱抑素C
Transient ischemic attackCarotid artery stenosisColor Doppler ultrasoundBlood flow parametersUric acidCystatin C
《中华神经创伤外科电子杂志》 2023 (5)
289-294,6
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