三维超声技术对颈动脉斑块与脑卒中相关性的研究

发布时间：2018-03-20 18:23

本文选题：三维超声　切入点：颈动脉斑块　出处：《暨南大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:三维超声飞速发展,目前三维超声技术已经逐步应用于临床,本实验应用三维超声技术来评价颈动脉斑块与脑卒中的相关性,通过三维超声测得的GSM、TPV、GSM与TPV比值,分别分析其与脑卒中的相关性。方法:随机选取神经内科患有颈动脉斑块患者149名,排除斑块位置较深及QLAB-VPQ软件无法识别的共17名,无颅脑影像资料的25名,余107名为受试者。据受试者颅脑的CT、MRI等影像结果将受试者分成脑卒中及非脑卒中两组,脑卒中组共66人;非脑卒中组共41人。受试者均行三维超声,通过QLAB-VPQ软件获取斑块的灰阶中位数(Gray-scaleMedian, GSM)及斑块体积(Total Plaque Volume, TPV),并计算出GSM与TPV的比值。运用统计学方法分别分析GSM、TPV、GSM/TPV比值与缺血性脑卒中的相关性。同时运用ROC曲线将相关性较高的统计量与与脑梗死结合分析,获取相应诊断节点。结果:A、B两组GSM、TPV、GSM/TPV比值进行Wilcoxon秩和检验,统计量分别为 GSM,统计量 Z=-1.644, P=0.032, TPV 统计量 Z=-4.515, P=0.043, GSM/TPV比值统计量Z=-4.857,P=0.000,在α=0.05水准,GSM、TPV、GSM/TPV差异均具有统计学意义。将全部GSM、TPV、GSM/TPV采用非条件Logistic回归分析,GSM 的 OR 值为 1.078(1.024-1.135)、TPV 的 OR 值为 1.037(1.019-1.056)、GSM/TPV 的 OR 值为 1.015 (1.007-1.024)。GSM、TPV、GSM/TPV 均可作为脑卒中的相关危险因素。根据ROC曲线结果可得出GSM结果(AUC=0.812,95%CI:0.729～0.894, P=0.000), TPV 的结果(AUC=0.806, 95% CI:0.729～0.891,P=0.000),GSM/TPV (AUC=0.821,95%CI:0.743～0.899, P=0.000)结论:GSM、TPV、GSM/TPV均与缺血性脑卒中的发生具有一定相关性,GSM及GSM/TPV比值越低发生脑卒中可能性越高,TPV值越大,脑卒中可能性越高。当TPV69mm3或GSM/TPV比值41.7或GSM41.1时,发生脑卒中风险较高。
[Abstract]:Objective: to evaluate the correlation between carotid plaques and stroke and to measure the ratio of GSM-T PVN to TPV by 3D ultrasound, the technique of 3D ultrasound has been applied in clinical practice at present, and the three dimensional ultrasound technique has been used to evaluate the correlation between carotid plaque and stroke. Methods: a total of 149 patients with carotid plaque in neurology department were randomly selected, 17 patients with deep plaque location and not recognized by QLAB-VPQ software were excluded, and 25 patients without craniocerebral imaging data were excluded. The remaining 107 subjects were divided into two groups: stroke group (66 cases) and non-stroke group (41 cases). Gray-scale medium (GSM) and total Plaque volume (TPV) of plaque were obtained by QLAB-VPQ software, and the ratio of GSM to TPV was calculated. The correlation between GSM-TPV-TPV ratio and ischemic stroke was analyzed by statistical method. Meanwhile, ROC curve was used to analyze the relationship between GSM-TPV-TPV ratio and ischemic stroke. Combining high correlation statistics with cerebral infarction, The corresponding diagnostic nodes were obtained. Results the Wilcoxon rank sum test was performed for the ratio of GSM / TPV to TPV / TPV in the two groups. The statistical values were: GSM-1.644, P0. 032, TPV statistics Zn-4.515, P0. 043, GSM/TPV ratio statistics Z0-4. 857 P0. 000. There were significant differences at 伪 0. 05 level. The OR value of GSM / TPV was 1.07824-1. 135 / TPV. The OR value of GSM- / TPV was 1.07824-1. 135% by non-conditional Logistic regression analysis. The OR value of GSM / TPV is 1.015 / 1.007-1.024n.GSM / TPV / TPV can be used as a risk factor for stroke. According to the ROC curve, we can conclude that the GSM result AUC0.81295CIV: 0.7290.894, P0.0000.000, TPV results are 0.806,95CI0.7296-0.891P0.0000.000 GSM / TPV / C0.82195CI0.743 / 0.899, P = 0.000) conclusion there is a certain correlation between the incidence of ischemic stroke and the incidence of AUC 0.806,95CI0.729 ~ 0.891P0.000). The lower the ratio of GSM/TPV to GSM/TPV, the higher the probability of stroke. The higher the risk of stroke, the higher the risk of stroke was when the ratio of TPV69mm3 or GSM/TPV was 41. 7 or GSM41.1.
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R743.3

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