Objective To analyze the predictive value of carotid artery ultrasound parameters on the nature of carotid plaque and poor prognosis of patients with acute cerebral infarction(ACI).Methods This was a retrospective study.Totally 106 ACI patients who completed 3-month follow-up in the 81th Group Army Hospital of the PLA and the First Hospital of Zhangjiakou from October 2020 to October 2023 were enrolled.According to the examination results of postoperative plaque pathological,the patients were assigned into the vulnerable plaque group(n=42)and the stable plaque group(n=64).The prognosis of patients was evaluated according to the modified Rankin scale(mRS)score at 3 months after operation.The patients with mRS score ≤ 2 points were included in the good prognosis group(n=30),and those with mRS score＞2 points were included in the poor prognosis group.Carotid artery ultrasound parameters(including plaque volume,plaque thickness,normalized wall index[NWI],gray-scale median[GSM])and baseline data were statistically analyzed.The receiver operating characteristic curve(ROC)was plotted to analyze the predictive value of carotid ultrasound parameters on the nature of carotid plaque and prognosis of ACI patients.Binary logistic regression was performed to analyze the risk factors of poor prognosis of ACI patients.Results The level of NWI in vulnerable plaque group was significantly higher than that of stable plaque group,but GSM was significantly lower(P＜0.05).There was no difference in plaque volume and plaque thickness between the two groups(P＞0.05).The results of ROC curve showed that the areas under curve(AUC)of NWI,GSM and their combined detection in evaluating the carotid properties of ACI patients were all＞0.70,which had certain predictive value,and the combined detection was the highest.The NIHSS score and NWI in the poor prognosis group were significantly higher than those of the good prognosis group,the GSM level was significantly lower than that of the good prognosis group,and the proportions of patients with pooled hyperlipidemia or diabetes were significantly higher than those of the good prognosis group(P＜0.05).The results of binary logistic regression analysis verified that high NIHSS score,pooled hyperlipidemia or diabetes,and high NWI were risk factors for poor prognosis in ACI patients(OR＞1,P＜0.05),while high GSM was a protective factor for poor prognosis in ACI patients(OR＜1,P＜0.05).The results of ROC curve proved that the AUC of NWI,GSM and their combined detection in evaluating the poor prognosis of ACI patients was＞0.70,with certain predictive value,and the combined detection was the highest.Conclusion Carotid artery ultrasound parameters in patients with ACI can effectively evaluate the nature of carotid plaques and predict the risk for poor prognosis.Targeted interventions can be taken to improve the prognosis of ACI patients with high risk.
acute cerebral infarctioncarotid artery ultrasoundnature of carotid plaqueprognosisprediction
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