Mitchell Carol C, Wilbrand Stephanie M, Kundu Bornali, Steffel Catherine N, Varghese Tomy, Meshram Nirvedh H, Li Geng, Cook Thomas D, Salamat M Shahriar, Dempsey Robert J
Department of Medicine, Cardiovascular Medicine Division, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Ultrasound Med Biol. 2017 Sep;43(9):1861-1867. doi: 10.1016/j.ultrasmedbio.2017.04.025. Epub 2017 Jun 20.
The purpose of this study was to determine the relationship between symptomatic status, transcranial Doppler (TCD) microemboli presence and plaque histopathology findings. TCD was performed on 60 patients (37 symptomatic, 23 asymptomatic) before undergoing clinically indicated carotid endarterectomy. The frequency of microemboli signals was not significantly different between symptomatic and asymptomatic subject groups (p = 0.88) and there were no differences observed in the macroscopic or histopathology scoring of these plaques (p-values all > 0.05). The presence of microemboli was associated with an ulceration score (regardless of symptomatic or asymptomatic status, p = 0.034), with a one-level increase in ulceration rating associated with an odds ratio of 5.86 (95% [CI] 1.55, 43.4). These findings suggest that both symptomatic and asymptomatic patients may have plaque with similar features of instability and ability to create emboli. Thus, identifying new ways to measure plaque instability may provide important information for optimizing treatment to prevent future stroke.
本研究的目的是确定症状状态、经颅多普勒（TCD）微栓子的存在与斑块组织病理学发现之间的关系。在60例患者（37例有症状，23例无症状）接受临床指征的颈动脉内膜切除术前进行了TCD检查。有症状和无症状受试者组之间微栓子信号的频率无显著差异（p = 0.88），这些斑块的宏观或组织病理学评分也无差异（p值均>0.05）。微栓子的存在与溃疡评分相关（无论有症状或无症状状态，p = 0.034），溃疡分级每增加一级，比值比为5.86（95%[CI]1.55，43.4）。这些发现表明，有症状和无症状患者的斑块可能具有相似的不稳定特征和产生栓子的能力。因此，确定测量斑块不稳定的新方法可能为优化治疗以预防未来中风提供重要信息。
