| 摘要: |
| 目的：探讨多模态超声诊断高血压伴高同型半胱氨酸血症患者颈动脉粥样硬化斑块的临床价值。方法：选取2019年5月-2021年6月于本院行常规超声检查发现颈动脉粥样硬化斑块的120例高血压伴高同型半胱氨酸血症患者，术前均行常规超声、超声造影（CEUS）以及弹性成像（EI）检查。以病理结果为金标准，根据斑块稳定性分为不稳定斑块组（64例）和稳定斑块组（56例）。比较两组之间不同超声检查特征的差异。采用受试者工作特征（ROC）曲线分析常规超声、CEUS以及EI单独或联合诊断不稳定斑块的效能。结果：不稳定斑块组的重度狭窄和完全闭塞、表面不规则、有钙化结节以及低回声区、强化程度（Ⅲ、Ⅳ级）人数占比以及斑块厚度、弹性评分显著高于稳定斑块组（P<0.05），不稳定斑块组的应变率显著低于稳定斑块组（P<0.05）。常规超声、CEUS、EI三者联合诊断高血压伴高同型半胱氨酸血症患者颈动脉粥样硬化斑块为不稳定斑块的曲线下面积均高于上述检查方式单独应用。结论：多模态超声对高血压伴高同型半胱氨酸血症患者颈动脉粥样硬化斑块的稳定性有一定的鉴别诊断价值，有助于提高该疾病的诊断符合率。 |
| 关键词: 颈动脉粥样硬化 高血压 多模态超声 同型半胱氨酸 不稳定斑块 |
| DOI： |
| 投稿时间：2022-01-07修订日期：2022-04-08 |
| 基金项目:广东省医学科研基金立项项目(A20182374) |
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| The clinical value of multimodal ultrasound in the diagnosis of carotid atherosclerotic plaque in patients with hypertension and hyperhomocysteinemiaCAO Wen1, REN Cui-long1, Sun Yan-xia2 |
| CAO Wen |
| () |
| Abstract: |
| Objective: To explore the clinical value of multimodal ultrasound in the diagnosis of carotid atherosclerotic plaque in patients with hypertension and hyperhomocysteinemia. Methods: We selected 120 patients with hypertension and hyperhomocysteinemia who had carotid atherosclerotic plaques under routine ultrasound examination in our hospital from May 2019 to June 2021. All patients underwent conventional ultrasound and contrast-enhanced ultrasound (CEUS) and elastography (EI) examination before surgery. Taking pathological results as the gold standard, according to the stability of plaques, they were divided into unstable plaque group (64 cases) and stable plaque group (56 cases). Compared the differences in the characteristics of different ultrasound examinations between the two groups. The receiver operating characteristic (ROC) curve was used to analyze the effectiveness of conventional ultrasound, CEUS and EI alone or in combination in diagnosing unstable plaque.Results: In the unstable plaque group, the proportion of the number of people with severe stenosis and complete occlusion, irregular surface, calcified nodules and hypoechoic areas, enhancement degree (grade Ⅲ, Ⅳ), and the plaque thickness and elasticity score were significantly higher than those in the stable plaque group (P<0.05), the strain rate of the unstable plaque group was significantly lower than that of the stable plaque group (P<0.05). The area under the curve of carotid atherosclerotic plaques in patients with hypertension and hyperhomocysteinemia diagnosed as unstable plaques by conventional ultrasound, CEUS and EI The values are all higher than the above-mentioned inspection methods used alone. Conclusion: Multimodal ultrasound has a certain value in the differential diagnosis of the stability of carotid atherosclerotic plaque in patients with hypertension and hyperhomocysteinemia, and helps to improve the diagnostic coincidence rate of the disease. |
| Key words: Atherosclerosis Hypertension Multimodal ultrasound Homocysteine Unstable plaque |
