Evaluation value of carotid ultrasound combined with serum HbA1c and FIB in acute anterior circulation cerebral infarction

doi:10.11958/20220168

Abstract

Abstract:

Objective To investigate the application value of carotid ultrasound quantitative parameters combined with serum glycosylated hemoglobin (HbA1c) and fibrinogen (FIB) in the assessment of acute anterior circulation cerebral infarction. Methods Ninety-three patients with acute anterior circulation cerebral infarction were collected as the cerebral infarction group, and 50 healthy individuals were used as the control group. The peak systolic flow velocity (PSV),end-diastolic flow velocity (EDV) and carotid intima-media thickness (IMT) of internal carotid artery were measured by carotid ultrasound. Serum HbA1c and FIB levels were determined. The above-mentioned indicators in patients with cerebral infarction in different conditions were compared. The relationship between these indicators and cerebral infarction and its condition and these indicators alone or in combination in diagnosis and condition evaluation were analyzed. Results The PSV, EDV, IMT, serum HbA1c and FIB levels were significantly larger/higher in the cerebral infarction group than those of the control group (P<0.05). Logistic regression analysis showed that the higher levels of EDV, IMT, HbA1c and FIB were risk factors for cerebral infarction (P<0.05). The area under the curve values and 95%CI of EDV, IMT, HbA1c, FIB alone and combined to diagnose cerebral infarction were 0.770 (0.683-0.857), 0.852 (0.788-0.917), 0.799 (0.717-0.880), 0.829 (0.762-0.896) and 0.970 (0.947-0.992). The IMT and FIB were significantly higher in the moderate group and the severe group than those in the mild group. The HbA1c was significantly higher in the severe group than that in the mild group and the moderate group, and the FIB was higher than that in the moderate group (P<0.05). Pearson correlation analysis showed that PSV, IMT, HbA1c and FIB were positively correlated with the NIHSS score (P<0.05). Logistic regression analysis showed that the higher IMT and FIB were risk factors for moderate and severe cerebral infarction. The area under the curve values and 95%CI of IMT, FIB alone and combined to diagnose moderate to severe cerebral infarction were 0.840 (0.758-0.923), 0.784 (0.687-0.880) and 0.882 (0.809-0.954). Conclusion Patients with anterior circulation cerebral infarction may be accompanied by changes in carotid artery ultrasound quantitative parameters and serum HbA1c and FIB levels. EDV, IMT, HbA1c and FIB are related to the occurrence of cerebral infarction, and IMT and FIB are related to the severity of cerebral infarction.

Key words: cerebral infarction, atherosclerosis, ultrasonography,doppler,color, hemoglobin A,glycosylated, carotid intima-media thickness, fibrinogen, anterior circulation, glycosylated hemoglobin

CLC Number:

R743.33

Figures/Tables 9

References 24

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组别	n	PSV （cm/s）	EDV （cm/s）	IMT （mm）	HbA1c （%）	FIB （g/L）
对照组	50	69.1±8.3	18.59±4.37	0.94±0.10	7.83±1.54	2.83±0.51
脑梗死组	93	77.8±8.9	23.05±3.02	1.12±0.14	9.33±1.03	4.01±1.08
t		5.689^＊＊	7.160^＊＊	8.189^＊＊	6.937^＊＊	7.294^＊＊

组别	n	PSV （cm/s）	EDV （cm/s）	IMT （mm）	HbA1c （%）	FIB （g/L）
对照组	50	69.1±8.3	18.59±4.37	0.94±0.10	7.83±1.54	2.83±0.51
脑梗死组	93	77.8±8.9	23.05±3.02	1.12±0.14	9.33±1.03	4.01±1.08
t		5.689^＊＊	7.160^＊＊	8.189^＊＊	6.937^＊＊	7.294^＊＊

指标	β	SE	Wald χ²	P	OR	OR 95%CI
PSV	0.076	0.044	2.939	0.086	1.079	0.989~1.176
EDV	0.364	0.108	11.363	0.001	1.438	1.164~1.777
IMT	10.716	3.068	12.198	<0.001	45 092.968	110.241~1.844×10⁷
HbA1c	1.243	0.332	14.053	<0.001	3.466	1.810~6.639
FIB	1.285	0.641	4.014	0.045	3.615	1.028~12.710
常量	-37.976	7.457	25.934	<0.001	<0.001	-

指标	β	SE	Wald χ²	P	OR	OR 95%CI
PSV	0.076	0.044	2.939	0.086	1.079	0.989~1.176
EDV	0.364	0.108	11.363	0.001	1.438	1.164~1.777
IMT	10.716	3.068	12.198	<0.001	45 092.968	110.241~1.844×10⁷
HbA1c	1.243	0.332	14.053	<0.001	3.466	1.810~6.639
FIB	1.285	0.641	4.014	0.045	3.615	1.028~12.710
常量	-37.976	7.457	25.934	<0.001	<0.001	-

指标	AUC及95%CI	截断值	敏感度（%）	特异度（%）	约登指数
EDV	0.770（0.683~0.857）	19.6 cm/s	93.50	58.00	0.515
IMT	0.852（0.788~0.917）	1.02 mm	73.10	84.00	0.571
HbA1c	0.799（0.717~0.880）	8.42%	82.80	70.00	0.528
FIB	0.829（0.762~0.896）	3.04 g/L	76.30	82.00	0.583
联合诊断	0.970（0.947~0.992）	-	83.90	96.00	0.799