Background Carotid atherosclerotic plaque is closely related to the occurrence of ischemic cerebral stroke (ICS), and ultrasound is the predominant method for cervical vascular disease screening.
Objective To analyze the correlation between ultrasonic detection indicators of carotid artery plaque and ICS in middle-aged and elderly patients, so as to improve the value of ultrasonic diagnosis and the efficiency of ICS screening by using ultrasonographic features of carotid artery plaque as early warning indicators and simplifying the clinical evaluation path.
Methods The patients aged 45 years or older who were admitted to our hospital from September 2017 to November 2019 were collected for two groups, patients with ICS were included in the ICS group and patients without ICS were included in the control group.
Results Totally 992 patients were included in the ICS group and 1 117 patients in the control group. There was no statistical difference in age between the two groups (P＞0.05), and the proportion of male/female patients in the ICS group was higher than that in the control group (594/398 vs 493/624, P＜0.01). Ultrasound results showed that there were significant differences between the two groups in plaque formation, plaque number, echotexture, morphology and carotid artery stenosis (all P＜0.05). The ratio of patients with carotid atherosclerotic plaque in the ICS group was higher than that in the control group (86.90% vs 69.92%, P＜0.01). The ratios of multiple plaque, uneven plaque and irregular plaque in the ICS group were higher than that in the control group (95.71% vs 88.09%, 51.62% vs 45.45%, 24.13% vs 16.90%, all P＜0.05). The ratio of carotid artery stenosis in the ICS group was significantly higher than that in the control group (18.33% vs 11.91%, P＜0.01). The ratio of severe carotid artery stenosis or occlusion in the ICS group was also higher than that in the control group (3.71% vs 1.15%, 2.09% vs 0.51%, P＜0.01, respectively). Multivariate Logistic regression analysis showed that plaque number (OR=1.702), plaque morphology (OR=1.381) and carotid artery stenosis (OR=1.435) were correlated with the occurrence of ICS in middle-aged and elderly patients (all P＜0.05).
Conclusion Plaque formation in carotid artery is a relevant and important predictor of ICS in middle-aged and elderly patients. In the ultrasonic features of plaque, the number, morphology and whether the plaque caused carotid artery stenosis are related to the occurrence of this disease. The proportion and severity of carotid artery stenosis are higher in the ICS group.
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