CAJ | 학술논문

目的探讨早期神经功能恶化(early neurological deterioration,END)急性卒中患者的颈动脉粥样硬化超声特征.方法 END定义为人院第7天时国立卫生研究院卒中量表评分较入院时至少增加2分.128例入院24 h内接受颈动脉超声检奁的急性缺血性卒中患者中,38例出现END的患者作为END组,40例危险因素相匹配的非END患者作为非END组.比较两组颈动脉粥样硬化超声特征.结果 END组斑块积分[(16.7±4.4)mm对(13.3±3.5)mm,t=2.673,P=0.009)、内膜-中膜横截面积[(26.4±8.5)mm2对(20.5±6.8)mm2,t=3.394,P=0.001]、动脉僵硬指数(28.94±4.29对21.22±5.85,t=6.618,P:0.000)以及小稳定斑块(66.7%对43.3%,χ2=9.164,P=0.003)、偏心性斑块(62.8%对45.6%,χ2=5.008,P=0.025)、狭窄≥50%(71.1%对37.5%,χ2=8.828,P=0.003)和负性重构(28.9%对7.5%,χ2=6.087,P=0.014)的构成比均显著高于非END组,而扩张系数[(14.74±8.66)×10-6/Pa对(19.16±9.35)×10-6/Pa,t=2.163,P=0.034]和顺应系数[(0.49±0.13)×10-4mm2/Pa对(0.58±0.11)×10-4 mm2/Pa,t=3.307,P:0.001]均显著低于END组.结论斑块积分、内膜-中膜横截面积、动脉僵硬度、不稳定斑块、偏心性斑块、狭窄≥50%、负性重构、扩张性和顺应性等超声特征可能有助于预测急性卒中的END.
목적 탐토조기신경공능악화(early neurological deterioration,END)급성졸중환자적경동맥죽양경화초성특정.방법 END정의위인원제7천시국립위생연구원졸중량표평분교입원시지소증가2분.128례입원24 h내접수경동맥초성검렴적급성결혈성졸중환자중,38례출현END적환자작위END조,40례위험인소상필배적비END환자작위비END조.비교량조경동맥죽양경화초성특정.결과 END조반괴적분[(16.7±4.4)mm대(13.3±3.5)mm,t=2.673,P=0.009)、내막-중막횡절면적[(26.4±8.5)mm2대(20.5±6.8)mm2,t=3.394,P=0.001]、동맥강경지수(28.94±4.29대21.22±5.85,t=6.618,P:0.000)이급소은정반괴(66.7%대43.3%,χ2=9.164,P=0.003)、편심성반괴(62.8%대45.6%,χ2=5.008,P=0.025)、협착≥50%(71.1%대37.5%,χ2=8.828,P=0.003)화부성중구(28.9%대7.5%,χ2=6.087,P=0.014)적구성비균현저고우비END조,이확장계수[(14.74±8.66)×10-6/Pa대(19.16±9.35)×10-6/Pa,t=2.163,P=0.034]화순응계수[(0.49±0.13)×10-4mm2/Pa대(0.58±0.11)×10-4 mm2/Pa,t=3.307,P:0.001]균현저저우END조.결론 반괴적분、내막-중막횡절면적、동맥강경도、불은정반괴、편심성반괴、협착≥50%、부성중구、확장성화순응성등초성특정가능유조우예측급성졸중적END.
Objective To explore the ultrasound characteristics of carotid atherosclerosis in acute stroke patients with early neurological deterioration (END). Methods END was defined as a increase by at least two points in the National Institutes of Health Stroke Scale between admission and day 7. Among 128 patients with acute stroke in whom carotid ultrasound examinations were performed within 24 hours after admission, 38 patients with END and 40risk-matched patients without END were included in the END group and the non-END group,respectively. The ultrasound characteristics of carotid atherosclerosis were compared in both groups. Results Plaque score (16.7 ±4.4 mm vs. 13.3 ±3.5 mm, t=2.673, P=0.009),intima-media cross-sectional area (26. 4 ± 8. 5 mm2 vs. 20. 5 ± 6. 8 mm2, t = 3. 394, P =0. 001), arterial stiffness index (28. 94 ±4. 29 vs. 21. 22 ±5. 85, t = 6. 618, P =0. 000), and the rates of unstable plaque (66. 7% υs. 43. 3%, χ2=9. 164, P =0. 003), eccentric plaque (62. 8% vs. 45. 6%, χ2=5. 008, P =0. 025), stenosis ≥50% (71. 1% vs. 37. 5%, χ2=8. 828, P =0. 003), and negative remodeling (28. 9% vs. 7. 5%, χ2=6.087, P =0.014) in the END group were significantly higher than those in the non-END group, while the distensibility coefficient ([14. 74 ±8. 66]×10-6/P υs. [19. 16 ±9.35] × 10-6/Pa, t =2. 163, P=0. 034)and compliance coefficient ([0.49 ±0. 13] × 10-4 mm2/Pa υs. [0. 58 ±0. 11] × 10-4 mm2/Pa,t =3.307, P =0. 001) were significantly lower than those in the non-END group. Conclusions The ultrasound characteristics such as plaque score, intima-media cross-sectional area, arterial stiffness index, unstable plaque, eccentric plaque, stenosis ≥ 50%, negative remodeling,distensibility and compliance may be useful to predict END in patients with acute stroke.