Xu Xiang, Guo Buchao, Chen Jie, Xu Jing, Wei Linglin, Fang Ling, Xing Zhen, Luo Xinyao, Wang Xuan, Wu Liulei, Liu Xinxiu
Department of Ultrasound, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Department of Ultrasound, Binhai Campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fuzhou, China.
Sci Rep. 2025 Apr 16;15(1):13106. doi: 10.1038/s41598-025-96975-8.
In the last decade, the incidence of stroke among young adults has risen globally. The relevance of carotid intima-media thickness (IMT) and plaque in predicting ischemic stroke (IS) in this population remains uncertain. This study investigated the relationship between ultrasound-evaluated carotid wall properties and occurrence and severity of IS in young adults. Young adults (n = 147) aged 18-50 years with IS and 294 age- and sex-matched controls were included. Ultrasound-assessed variables included carotid atherosclerosis, perivascular adipose tissue, and arterial stiffness. Ultrasound parameters included IMT, plaque presence, extra-media thickness (EMT), and flow augmentation index (FAI). Multivariate and ROC curve analyses were conducted. All ultrasound parameters were elevated in the IS group. Carotid EMT and FAI were associated with IS, while IMT and plaque were not. The multivariate model combining carotid EMT and FAI showed a superior area under the curve compared to models incorporating either parameter alone. Plaque presence and increased EMT thickness correlated with higher scores on the National Institutes of Health Stroke Scale. Carotid EMT and FAI are independent vascular risk factors for IS in young adults. The potential of EMT and plaque presence as biomarkers for assessing disease severity warrants further investigation.
在过去十年中，全球范围内年轻成年人中风的发病率有所上升。颈动脉内膜中层厚度（IMT）和斑块在预测该人群缺血性中风（IS）方面的相关性仍不确定。本研究调查了超声评估的颈动脉壁特性与年轻成年人IS的发生及严重程度之间的关系。研究纳入了147名年龄在18至50岁之间患有IS的年轻成年人以及294名年龄和性别匹配的对照组。超声评估的变量包括颈动脉粥样硬化、血管周围脂肪组织和动脉僵硬度。超声参数包括IMT、斑块存在情况、中膜外厚度（EMT）和血流增加指数（FAI）。进行了多变量分析和ROC曲线分析。IS组的所有超声参数均升高。颈动脉EMT和FAI与IS相关，而IMT和斑块则无关。与单独纳入任一参数的模型相比，结合颈动脉EMT和FAI的多变量模型显示出更高的曲线下面积。斑块存在情况和EMT厚度增加与美国国立卫生研究院卒中量表的更高分数相关。颈动脉EMT和FAI是年轻成年人IS的独立血管危险因素。EMT和斑块存在作为评估疾病严重程度生物标志物的潜力值得进一步研究。
