超声波回性带斑块可以预测未来的中风
M L Grønholdt1, B G Nordestgaard, T V Schroeder
1Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Osaka, Japan. mlg@dadlnet.dk
Circulation
|July 4, 2001
概括
光性心血管斑块预测症状患者的中风风险,但不预测无症状患者的风险. 斑块回声度和狭窄度可以改善中风风险评估和患者选择进行大脑动脉内关节切除术.
科学领域:
- 神经学 神经学
- 血管医学 血管医学
- 医疗成像医学成像
背景情况:
- 动脉狭窄是缺血性中风的重要危险因素.
- 预测心血管动脉样硬化患者中风风险仍然是一个临床挑战.
- 斑块特征,如回声,可能提供预后价值.
研究的目的:
- 为了前性地评估阴道状斑块回声能否预测中风的发展.
- 为了评估这种预测,无论是先前有症状的患者还是无症状的患者.
- 为了确定回声能否改善中风风险分层,超出狭窄度.
主要方法:
- 在246名患者 (111名无症状,135名有症状) 的前性研究中,动脉狭窄率>=50%.
- 高分辨率B模式超声波与计算机辅助图像处理评估了斑块回声性.
- 多普勒超声波评估了动脉狭窄的程度.
- 在4.4年内对ipsilateral缺血性中风的随访.
主要成果:
- 在随访期间观察到44次双侧性缺血性中风.
- 在有症状的患者中,光斑显著增加了中风风险 (相对风险 = 3.1).
- 在有症状的患者中,较高的狭窄度 (80-99%) 显示出增加风险的趋势 (RR=1.4),但回声清晰度是一个更强的预测因素.
- 在无症状患者中,没有发现斑块回声和中风风险之间的显著关联.
结论:
- 光性心动脉斑与显著狭窄症的症状个体的未来中风风险有关.
- 除了狭窄症的严重程度外,斑块回声感可能会提高患者选择 carotid endarterectomy 的情况.
- 这种成像标志物似乎无法预测心血管狭窄症无症状患者中风风险.
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