摘要
目的 探究CT血管造影(CTA)对高脂血症合并急性脑梗死(ACI)动脉粥样硬化患者临床症状和病情的评估价值.方法 选取2021 年7 月—2022 年7 月60 例高脂血症合并ACI动脉粥样硬化作为研究组,另选同期50例无高脂血症ACI动脉粥样硬化作为对照组.比较2 组CTA影像表现、血脂指标[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白B(ApoB)、低密度脂蛋白胆固醇(LDL-C)]、大脑中动脉血流动力学[收缩期峰值流速(Vs)、平均血流速度(Vm)]以及美国国立卫生研究院卒中量表(NIHSS)评分,分析研究组动脉粥样硬化斑块性质、血管狭窄程度与血脂指标、大脑中动脉血流动力学、NIHSS评分的相关性.分析研究组治疗前动脉粥样硬化斑块性质、血管狭窄程度与静脉溶栓早期疗效的关系.结果 2 组颈总动脉中部、颈总动脉分叉处动脉粥样硬化斑块性质、分布情况及血管狭窄程度比较差异有统计学意义(P＜0.05,P＜0.01).研究组血清TC、LDL-C、HDL-C、ApoB、TG水平及NIHSS评分均高于对照组,大脑中动脉Vs、Vm低于对照组(P＜0.05).研究组血管狭窄程度与血清TC、LDL-C、HDL-C、ApoB、TG水平及NIHSS评分呈正相关,与大脑中动脉Vs、Vm呈负相关(P＜0.01).研究组治疗前颈总动脉分叉处斑块性质、血管狭窄程度与早期疗效呈负相关(r =-0.706、-0.680,P＜0.05).结论 CTA检查对高脂血症合并ACI动脉粥样硬化患者血管狭窄程度、斑块性质具有较高评估价值,能为预测病情及评估预后提供依据.
Abstract
Objective To explore the value of CT angiography(CTA)in evaluating the clinical symptoms and condi-tions of patients with hyperlipidemia complicated with acute cerebral infarction(ACI)atherosclerosis.Methods Sixty pa-tients with hyperlipidemia complicated with ACI atherosclerosis from July 2021 to July 2022 were selected as the research group,and another 50 patients with ACI atherosclerosis but without hyperlipidemia during the same period were selected as the control group.CTA imaging findings,lipid indicators[triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),apolipoprotein B(ApoB),low-density lipoprotein cholesterol(LDL-C)],cerebral arterial hemody-namics[peak systolic flow velocity(Vs),mean blood flow velocity(Vm)]and the National Institutes of Health Stroke Scale(NIHSS)score were compared between the two groups.The correlation between atherosclerotic plaque nature,vascular steno-sis degree,blood lipid indicators,cerebral arterial hemodynamics,and NIHSS score in the research group was analyzed.The research group was treated with intravenous thrombolytic therapy,and the early curative effect was evaluated.The relationship between the nature of atherosclerotic plaque,the degree of vascular stenosis before treatment and the early curative effect of in-travenous thrombolytic therapy was analyzed in the research group.Results There were significant differences in the nature and distribution of atherosclerotic plaque and degree of vascular stenosis in the middle of common carotid artery and in the bi-furcation of carotid artery between the two groups(P＜0.05,P＜0.01).The levels of serum TC,LDL-C,HDL-C,ApoB,TG and NIHSS in the research group were higher than those in the control group,while the Vs and Vm of middle cerebral ar-tery were lower than those in the control group(P＜0.05).In the research group,the degree of vascular stenosis was posi-tively correlated with serum levels of TC,LDL-C,HDL-C,ApoB,TG and NIHSS score,and negatively correlated with Vs and Vm of middle cerebral artery(P＜0.01).In the research group,there was a negative correlation of the nature of plaque and the degree of vessel stenosis in the bifurcation of common carotid ortery with the early curative effect before treatment(r =-0.706,-0.680,P＜0.05).Conclusion CTA examination has a high value in evaluating the degree of vascular stenosis and the nature of plaque in patients with hyperlipidemia complicated with ACI atherosclerosis,and can provide a basis for pre-dicting the disease and evaluating the prognosis.
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