颈动脉超声预测心房颤动缺血性卒中的价值

张得梅; 王小妹; 李广陵; 郭雪娅

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颈动脉超声预测心房颤动缺血性卒中的价值

临床研究 | 更新时间：2025-10-15

- 颈动脉超声预测心房颤动缺血性卒中的价值
- The value of carotid ultrasound in predicting ischemic stroke in atrial fibrillation
- 临床心电学杂志 2022年第4期页码：279-284
- 作者机构：
  
  1. 兰州大学
  2. 兰州大学第二医院心内科
- 作者简介：
- 基金信息：
- DOI：
  中图分类号： R541.75;R743.3
- 纸质出版：2022
- 稿件说明：
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张得梅, 王小妹, 李广陵, 等. 颈动脉超声预测心房颤动缺血性卒中的价值[J]. 临床心电学杂志, 2022,(4):279-284.

Zhang demei, Wang xiaomei, Li guangling, et al. The value of carotid ultrasound in predicting ischemic stroke in atrial fibrillation[J]. 2022, (4): 279-284.
张得梅, 王小妹, 李广陵, 等. 颈动脉超声预测心房颤动缺血性卒中的价值[J]. 临床心电学杂志, 2022,(4):279-284. DOI：

Zhang demei, Wang xiaomei, Li guangling, et al. The value of carotid ultrasound in predicting ischemic stroke in atrial fibrillation[J]. 2022, (4): 279-284. DOI：

摘要

目的探讨颈动脉粥样硬化与心房颤动缺血性卒中的相关性，从而评估颈动脉超声预测心房颤动缺血性卒中的价值。方法采用病例对照研究，收集符合纳入标准和排除标准的房颤患者194例(房颤组n=194)，房颤合并缺血性卒中患者138例(脑卒中组n=138)，研究组为脑卒中组。分析两组研究对象的一般资料和颈动脉粥样硬化患病率差异；采用多因素Logistic回归分析颈动脉粥样硬化指标与房颤缺血性卒中的相关性。结果脑卒中组检出颈动脉内-中膜增厚(Carotid Intima-Media Thickness

CIMT)、颈动脉斑块、稳定斑块、不稳定斑块、溃疡斑块的比例均高于房颤组(77.5.%vs. 66.5%、70.3.%vs. 55.7%、11.6%vs. 10.8%、58.7%vs. 44.8%、64.5%vs. 43.8%

p值均

0.05)；脑卒中组斑块面积大于房颤组(z=-3.532

0.001)，多发斑块(c

=16.252

0.001)、溃疡斑块(c

=14.255

0.01)的比例显著地高于房颤组，差异均有统计学意义(p

0.05)。房颤组和脑卒中组在斑块部位、颈动脉狭窄

50%的差异上不具有统计学意(p>0.05)。进一步Logistic回归分析提示，校正单因素分析中差异有统计学意义的变量后，糖尿病、缺血性卒中史、颈动脉斑块、不稳定斑块、多发斑块、溃疡斑块是房颤缺血性卒中的危险因素(p

0.05)。结论心房颤动合并缺血性卒中的患者，CIMT、颈动脉斑块、不稳定斑块、溃疡斑块、多发斑块的发生率较高，与房颤缺血性卒中相关，暗示颈动脉超声检查可以提高房颤卒中风险预测。

Abstract

Objective To investigate the relationship between carotid atherosclerosis and ischemic stroke in atrial fibrillation

and to evaluate the value of carotid ultrasound in predicting ischemic stroke in atrial fibrillation.Methods In a case-control study

194 patients with atrial fibrillation（atrial fibrillation group

n=194） and 138patients with atrial fibrillation complicated with ischemic stroke（stroke group

n=138） were collected. The general data and the prevalence of carotid atherosclerosis between the two groups were analyzed

and the correlation between carotid atherosclerosis and ischemic stroke in atrial fibrillation was analyzed by multivariate logistic regression.Results The proportion of carotid intima-media thickening（Carotid Intima-Media Thickness CIMT）

carotid plaque

stable plaque

unstable plaque and ulcer plaque in stroke group was higher than that in atrial fibrillation group（77.5%vs. 66.5%

70.3% vs. 55.7%

11.6% vs. 10.8%

58.7% vs. 44.8%

64.5% vs. 43.8%

p<0.05）. The plaque area in the stroke group was larger than that in the atrial fibrillation group（p<0.001）

and the proportion of multiple plaques（c~2=16.252

p<0.001） and ulcer plaques（c~2=14.255

p<0.01） in the stroke group was significantly higher than that in the atrial fibrillation group（p<0.001）. There was no statistical significance in plaque location and carotid artery stenosis <50% between atrial fibrillation group and stroke group（p>0.05）. Further Logistic regression analysis showed that diabetes

previous ischemic stroke history

carotid plaque

unstable plaque

multiple plaque and ulcer plaque were the risk factors of ischemic stroke in atrial fibrillation after correcting the statistically significant variables in univariate analysis. Conclusions The incidence of CIMT

carotid plaque

unstable plaque

ulcer plaque and multiple plaque is higher in patients with atrial fibrillation with ischemic stroke

which is related to ischemic stroke in atrial fibrillation. Carotid ultrasound can improve the risk prediction of stroke in patients with atrial fibrillation.

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references

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