基于超声与代谢-炎症指标探讨急性脑梗死患者脑小血管病负荷的影响因素OA
Exploring Factors Influencing Cerebral Small Vessel Disease Burden in Patients With Acute Cerebral Infarction Based on Ultrasound and Metabolic-Inflammatory Indicators
目的 探讨急性脑梗死患者脑小血管病(CSVD)负荷的影响因素,评估颈动脉及经颅多普勒超声(TCD/TCCD)指标在脑小血管病负荷分层中的价值.方法 选取 2022 年 5 月至 2025 年 3 月期间在南阳医学高等专科学校第一附属医院确诊的 106 例急性脑梗死患者,根据CSVD负荷评估情况分为低负荷组(n=64)和高负荷组(n=42).比较两组基本资料、实验室指标、颈动脉超声及TCD/TCCD参数差异,并采用Logistic回归分析CSVD高负荷的独立危险因素.结果 高负荷组患者的空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、同型半胱氨酸(Hcy)、尿酸(UA)及C反应蛋白(CRP)水平均明显高于低负荷组,差异有统计学意义(P＜0.05).高负荷组患者的平均颈动脉内膜-中层厚度(cIMT)、总斑块面积、颈总动脉搏动指数(CCA-PI)及颈总动脉阻力指数(CCA-RI)显著升高,差异有统计学意义(P＜0.05);TCD/TCCD结果显示高负荷组大脑中动脉搏动指数(MCA-PI)、大脑中动脉阻力指数(MCA-RI)、大脑前动脉搏动指数(ACA-PI)及基底动脉搏动指数(BA-PI)均显著升高,差异有统计学意义(P＜0.05).多因素Logistic回归分析表明,每 10 μmol/L UA增加、每 1 mmol/L TC增加、每 0.1 单位CCA-RI/MCA-PI/ACA-PI增加是脑小血管病高负荷的独立危险因素(P＜0.05).结论 代谢-炎症相关指标以及超声指标如UA、TC、CCA-RI、MCA-PI和ACA-PI均是CSVD高负荷的独立危险因素,或可作为急性脑梗死患者CSVD负荷水平的有效参考依据.
Objective To investigate factors influencing the burden of cerebral small vessel disease(CSVD)in patients with acute cerebral infarction and to evaluate the value of carotid and transcranial Doppler ultrasonography(TCD/TCCD)parameters in stratifying CSVD burden.Methods A total of 106 patients with acute cerebral infarction diagnosed at the First Affiliated Hospital of Nanyang Medical College from May 2022 to March 2025 were enrolled.According to CSVD burden assessment.they were assigned to a low-burden group(n=64)or a high-burden group(n=42).Baseline characteristics.laboratory indicators.carotid ultrasound findings.and TCD/TCCD parameters were compared between the two groups.Logistic regression analysis was performed to identify independent risk factors for high CSVD burden.Results The high-burden group had significantly higher levels of fasting plasma glucose(FPG).glycated hemoglobin(HbA1c).total cholesterol(TC).homocysteine(Hcy).uric acid(UA).and C-reactive protein(CRP)than the low-burden group(P＜0.05).The mean carotid intima-media thickness(cIMT).total plaque area.common carotid artery pulsatility index(CCA-PI).and common carotid artery resistance index(CCA-RI)were significantly increased in the high-burden group(P＜0.05).TCD/TCCD findings showed that the pulsatility index(PI)and resistance index(RI)of the middle cerebral artery(MCA-PI and MCA-RI).the pulsatility index of the anterior cerebral artery(ACA-PI).and the pulsatility index of the basilar artery(BA-PI)were all significantly higher in the high-burden group(P＜0.05).Multivariable logistic regression analysis indicated that each 10 μmol/L increase in UA.each 1 mmol/L increase in TC.and each 0.1-unit increase in CCA-RI.MCA-PI.or ACA-PI were independent risk factors for high CSVD burden(P＜0.05).Conclusion Metabolic-inflammatory indicators and ultrasound parameters.including UA.TC.CCA-RI.MCA-PI.and ACA-PI.are independent risk factors for high CSVD burden and may serve as useful reference indicators for assessing CSVD burden in patients with acute cerebral infarction.
苏方欣;解德富;刘洁煜;王坤;潘延克
南阳医学高等专科学校第一附属医院 急诊科,河南 南阳 473000南阳医学高等专科学校第一附属医院 急诊科,河南 南阳 473000南阳医学高等专科学校第一附属医院 急诊科,河南 南阳 473000南阳医学高等专科学校第一附属医院 急诊科,河南 南阳 473000南阳医学高等专科学校第一附属医院 急诊科,河南 南阳 473000
医药卫生
急性脑梗死脑小血管病颈动脉超声经颅多普勒
acute cerebral infarctioncerebral small vessel diseasecarotid ultrasonographytranscranial Doppler ultrasonography
《临床研究》 2026 (2)
24-27,4
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