CAJ | 학술논문

目的：评估超声和血脂水平检测对颈动脉斑块稳定性诊断的临床应用价值。方法将2013年1月至2013年12月住院治疗的脑梗死病人60例作为观察组，门诊查体的健康人群60例作为对照组。分别对每一筛选合格并成功入组的病例进行病史采集和记录临床资料，检测血脂水平[三酰甘油（ TG）、总胆固醇（ TC）、低密度脂蛋白胆固醇（ LDL-C）和高密度脂蛋白胆固醇（ HDL-C）等指标）]，用超声进行颈动脉斑块信息采集和评估。结果观察组检出颈动脉斑块的总例数更高（ P ﹤0.05）。观察组UE评分≥5分患者比率显著高于对照组（ P ﹤0.05）。且观察组的血脂水平显著高于对照组（ P ﹤0.05），尤其是LDL-C指标。结论异常增高的LDL-C等血脂指标提示了脑梗死病人颈动脉粥样硬化不稳定性斑块的存在，而应用新型UE结合传统超声成像技术更显著的提高了超声检出病变组织的敏感度；超声、血脂水平对颈动脉斑块稳定性诊断的应用具有积极和实际的临床意义。
목적：평고초성화혈지수평검측대경동맥반괴은정성진단적림상응용개치。방법장2013년1월지2013년12월주원치료적뇌경사병인60례작위관찰조，문진사체적건강인군60례작위대조조。분별대매일사선합격병성공입조적병례진행병사채집화기록림상자료，검측혈지수평[삼선감유（ TG）、총담고순（ TC）、저밀도지단백담고순（ LDL-C）화고밀도지단백담고순（ HDL-C）등지표）]，용초성진행경동맥반괴신식채집화평고。결과관찰조검출경동맥반괴적총례수경고（ P ﹤0.05）。관찰조UE평분≥5분환자비솔현저고우대조조（ P ﹤0.05）。차관찰조적혈지수평현저고우대조조（ P ﹤0.05），우기시LDL-C지표。결론이상증고적LDL-C등혈지지표제시료뇌경사병인경동맥죽양경화불은정성반괴적존재，이응용신형UE결합전통초성성상기술경현저적제고료초성검출병변조직적민감도；초성、혈지수평대경동맥반괴은정성진단적응용구유적겁화실제적림상의의。
Objective To evaluate the role of ultrasonic elastograsphy and blood levels of lipids in diagnosis of stability of atherosclerotic plaque in carotid artery. Methods Sixty patients diagnosed as cerebral infarction during January 2013 to December 2013 were allocated in obser_vation group and 60 healthy persons taking health examination in outpatient service were allocated in control group for prospective study. All their clinical data and history records were studied according to the actual order one by one,and blood levels of lipids including three acyl glycerin ( TG),total cholesterol( TC),low density lipoprotein cholesterol( LDL-C)and high density lipoprotein cholesterolother( HDL-C)indicators were evaluated,information of carotid plaques had been recorded by using ultrasond combined with UE( ultrasonic elastography). Results Rele_vance ratio of total carotid plaques in observation group was higher( P ﹤0. 05). The total number of cases in two groups with UE scores at 4 or less points was not statistically different,but the number of cases with UE scores at 5 points or higher in observation group was significantly higher than those of control group( P ﹤0. 05). Blood levels of lipids especially the index of LDL-C were also significantly higher in observation group ( P ﹤0. 05). Conclusion Abnormally higher LDL-C lipid indexes mean the instability of atherosclerotic plaques in carotid arteries of patients with cerebral infarction,and application of new type UE combined with technique of traditional ultrasonic imaging can more significantly raise the sensitivity of ultrasonic detection of diseased tissues;and the application of ultrasound and detection of blood levels of lipids have practical clinical significance in demonstration of the stability of carotid plaques in carotid arteries.