影像科学与光化学2026，Vol.44Issue(4)：85-93,9.DOI:10.7517/issn.1674-0475.2026.04.13
颈动脉超声定量参数、sd-LDL、LDL亚型与急性脑梗死患者脑动脉狭窄的相关性及诊断价值研究
Study on the Correlation and Diagnostic Value of Carotid Ultrasound Quantita-tive Parameters,sd-LDL,LDL Subtypes and Cerebral Artery Stenosis in Patients with Acute Cerebral Infarction
摘要
Abstract
Objective:To investigate the association of integrated carotid ultrasound quantitative parameters,small dense low-density lipoprotein(sd-LDL),and low-density lipoprotein(LDL)subfractions with significant cerebral artery stenosis in patients with acute cerebral infarction,and to identify independent influencing factors and construct a combined diagnostic model to overcome the limitations of single indicators.Methods:347 patients with acute cerebral infarction admitted to our hospital from January 1,2023,to January 31,2024 were enrolled.Stenosis rate was calculated according to the NASCET criteria.Patients were categorized into:no stenosis group(n=42),mild stenosis(1％～29％)group(n=118),moderate stenosis(30％～69％)group(n=104),and severe stenosis(70％～99％)group(n=83).Using a 50％stenosis rate as the cutoff,the 305 patients with cerebral artery stenosis were further divided into a significant stenosis group(n=165)and a non-significant stenosis group(n=140).General data,carotid ultrasound parameters(intima-media thickness,plaque number/area),and serological markers(sd-LDL,LDL subfractions,apolipoprotein B,etc.)were collected.Spearman rank correlation and multivariate Logistic analysis were used to examine the correlation between indicators and stenosis degree,and to identify influencing factors for significant cerebral artery stenosis.Receiver operating characteristic curves were plotted to evaluate the diagnostic performance of indicators for significant stenosis.Results:Intima-media thickness,plaque number,plaque area,sd-LDL,and LDL-B subtype were positively correlated with stenosis degree(all P＜0.001),while LDL-A subtype was negatively correlated(P＜0.001).LDL-Ⅰ subtype showed a weak negative correlation(P＜0.05).Multivariate Logistic regression analysis identified diabetes mellitus,intima-media thickness,plaque number,plaque area,apolipoprotein B(Apo-B),sd-LDL,LDL-A,and LDL-B as independent influencing factors for significant cerebral artery stenosis(all P＜0.05).LDL-C did not enter the final regression model,indicating it is not an independent influencing factor.The Hosmer-Lemeshow goodness-of-fit test showed x2=6.669,P=0.573,indicating good model fit.The area under the curve for the combined prediction of significant stenosis by the above indicators was 0.849,with a sensitivity of 76.40％and a specificity of 80.70％,outperforming the diagnostic efficacy of any single indicator.Conclusion:Carotid ultrasound quantitative parameters,sd-LDL levels,and LDL subfraction distribution are closely associated with significant cerebral artery stenosis in patients with acute cerebral infarction.The combined diagnostic model demonstrates excellent performance and may provide a reference for early clinical identification of high-risk patients.关键词
颈动脉超声定量参数/sd-LDL/LDL亚型/急性脑梗死/脑动脉狭窄/相关性/诊断价值Key words
carotid ultrasound quantitative parameters/sd-LDL/LDL subfractions/acute cerebral infarction/cerebral artery stenosis/correlation/diagnostic value分类
医药卫生引用本文复制引用
左凤同,王晓燕,范永建,董爱勤,王文慧,张海柳,刘辉..颈动脉超声定量参数、sd-LDL、LDL亚型与急性脑梗死患者脑动脉狭窄的相关性及诊断价值研究[J].影像科学与光化学,2026,44(4):85-93,9.基金项目
2023年度河北省卫生健康委员会医学科学研究课题计划项目(20232108). （20232108）
