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颈动脉斑块最大面积与急性缺血性脑卒中患者预后的关系。

Relationship between maximum carotid plaque area and prognosis of patients with acute ischaemic stroke.

机构信息

Tangshan Gongren Hospital, Tangshan City, Hebei Province, China.

The Third Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, China.

出版信息

Ir J Med Sci. 2024 Oct;193(5):2501-2507. doi: 10.1007/s11845-024-03739-w. Epub 2024 Jun 18.

Abstract

OBJECTIVE

In this study, the relationship between maximum carotid plaque area and stroke prognosis was analysed by carotid ultrasonography, and the relevant risk factors affecting the prognosis of acute ischaemic stroke (AIS) were investigated to provide novel insights into stroke prevention and management.

METHODS

A total of 205 AIS patients with carotid plaques were included in this study. Based on the mRS score at discharge, patients with AIS were classified into the good prognosis group (mRS ≤ 2) and poor prognosis group (mRS ≥ 3). SPSS 25.0 was used to analyse the data. Univariate and multivariate analyses were performed on the two groups with good and poor prognosis. Comparison between good and poor prognosis in patients with AIS in different circulatory systems was performed using the Kruskal-Wallis test. Differences were considered statistically significant at P < 0.05.

RESULTS

Comparison of baseline data revealed differences in carotid plaque diameter, carotid intima-media thickness, maximum carotid plaque area, history of previous stroke and plaque echogenicity between the good and poor prognosis groups (P < 0.05). Results of multifactorial analyses of logistic binary regression indicated that history of previous stroke and maximum carotid plaque area were predictors of poor prognosis, with odds ratio of 2.515 (95%CI [1.327-4.764]) and 1.019 (95%CI [1.006-1.032]), respectively.

CONCLUSION

The maximum carotid plaque area and history of previous stroke are important predictors for assessing prognosis in patients with AIS.

摘要

目的

本研究通过颈动脉超声分析最大颈动脉斑块面积与脑卒中预后的关系,并探讨影响急性缺血性脑卒中(AIS)预后的相关危险因素,为脑卒中的预防和管理提供新的思路。

方法

共纳入 205 例伴有颈动脉斑块的 AIS 患者。根据出院时 mRS 评分,将 AIS 患者分为预后良好组(mRS≤2)和预后不良组(mRS≥3)。采用 SPSS 25.0 对两组数据进行分析。对预后良好和预后不良的两组患者进行单因素和多因素分析。采用 Kruskal-Wallis 检验比较不同循环系统 AIS 患者的良好和不良预后。P<0.05 为差异有统计学意义。

结果

基线数据比较显示,两组间颈动脉斑块直径、颈动脉内中膜厚度、最大颈动脉斑块面积、既往卒中史和斑块回声强度存在差异(P<0.05)。Logistic 二项回归多因素分析结果显示,既往卒中史和最大颈动脉斑块面积是预后不良的预测因素,其优势比分别为 2.515(95%CI[1.327-4.764])和 1.019(95%CI[1.006-1.032])。

结论

最大颈动脉斑块面积和既往卒中史是评估 AIS 患者预后的重要预测因素。

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