Kawnayn Ghulam, Kabir Humayun, Huq Muhammad Rezeul, Chowdhury Md Ismail, Shahidullah Md, Hoque Bonny Sadar, Anwar Mahin Binte
Neurology, Combined Military Hospital, Dhaka, BGD.
Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD.
Cureus. 2023 Jul 5;15(7):e41384. doi: 10.7759/cureus.41384. eCollection 2023 Jul.
Carotid atherosclerosis is an important etiological factor for ischemic stroke. Early carotid lesion detection may prevent further strokes. Doppler ultrasound measures carotid artery blood flow, intima-media thickness, stenosis, plaques, and lumen and wall changes.
The objective of this study is to determine the association of carotid plaque size (CPS), carotid intima-media thickness (CIMT), resistive index (RI), and pulsatility index (PI) with acute ischemic stroke.
A total of 60 participants were taken, including 30 cases and 30 age- and sex-matched controls. Patients with acute ischemic stroke were included as cases and age- and sex-matched healthy volunteers were included as controls. A carotid duplex study was done in both groups, and the findings were compared.
The mean age of the ischemic stroke cases was 63.33±10.79 years; more than half were aged >60 years. Male patients were 73.3% and female patients were 26.7% of the cases. Age and gender were statistically similar (p>0.05) in groups (cases and controls). The plaques were homogenous in 30% of patients, calcified in 26.7%, and mixed in 6.7%. About 36.6% of patients did not have any plaque. CPS was greater among cases than controls in the right and left internal and left common carotid arteries; however, it was not statistically significant (p>0.05). The mean CIMT was 0.79±0.10 mm on the right side and 0.90±0.17 mm on the left side among cases. CIMT was significantly higher in the cases group than in the controls (p<0.05). The mean RI was significantly greater in the left common carotid artery (CCA) among the cases than in the controls (p<0.05). Patients aged over 60 years had significantly higher RI and PI values in the left internal carotid artery (ICA) compared to the younger cases (p<0.05). Smoking history had a significant association with left CCA RI and PI values (p<0.05). However, RI, PI, CPS, and CIMT among cases were similar in different groups like diabetic, non-diabetic, hypertensive, and non-hypertensive patients (p>0.05).
CIMT was significantly thicker among the patients with ischemic stroke compared to the control group. RI in the left CCA was significantly greater among the stroke patients than in the control group. The age of the patient and smoking habit had an association with RI and PI values. Most of the parameters were found to be significant on the left side, suggesting carotid atherosclerosis may not be symmetrical. A large-scale further study is needed to see the association of these variables with ischemic stroke patients.
颈动脉粥样硬化是缺血性中风的重要病因。早期发现颈动脉病变可预防进一步的中风。多普勒超声可测量颈动脉血流、内膜中层厚度、狭窄、斑块以及管腔和管壁变化。
本研究的目的是确定颈动脉斑块大小（CPS）、颈动脉内膜中层厚度（CIMT）、阻力指数（RI）和搏动指数（PI）与急性缺血性中风之间的关联。
共纳入60名参与者，包括30例病例和30名年龄及性别匹配的对照。急性缺血性中风患者作为病例，年龄及性别匹配的健康志愿者作为对照。两组均进行了颈动脉双功超声检查，并比较检查结果。
缺血性中风病例的平均年龄为63.33±10.79岁；超过一半的患者年龄>60岁。病例中男性患者占73.3%，女性患者占26.7%。两组（病例组和对照组）的年龄和性别在统计学上相似（p>0.05）。30%的患者斑块为均匀性，26.7%为钙化性，6.7%为混合性。约36.6%的患者没有任何斑块。病例组右侧和左侧颈内动脉及左侧颈总动脉的CPS均大于对照组；然而，差异无统计学意义（p>0.05）。病例组右侧CIMT平均为0.79±0.10mm，左侧为0.90±0.17mm。病例组的CIMT显著高于对照组（p<0.05）。病例组左侧颈总动脉（CCA）的平均RI显著高于对照组（p<0.05）。60岁以上患者左侧颈内动脉（ICA）的RI和PI值显著高于年轻病例（p<0.05）。吸烟史与左侧CCA的RI和PI值显著相关（p<0.05）。然而，病例组中不同组（如糖尿病、非糖尿病、高血压和非高血压患者）的RI、PI、CPS和CIMT相似（p>0.05）。
与对照组相比，缺血性中风患者的CIMT显著增厚。中风患者左侧CCA的RI显著高于对照组。患者年龄和吸烟习惯与RI和PI值有关。大多数参数在左侧具有显著性，提示颈动脉粥样硬化可能不对称。需要进行大规模的进一步研究以观察这些变量与缺血性中风患者的关联。
