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目的本研究探讨MES结合ESRS预测无症状患者发生缺血性脑卒中的应用价值。以及影响MES的相关因素。方法选取ESRS≥3分患者182例,所有患者行MES监测并随访。结果 182例患者MES阳性27例(14.8%)。MES阳性组与阴性组高密度脂蛋白[(0.96±0.21)mmol/L比(1.06±0.24)mmol/L,t=2.616,P<0.05]及血小板计数[(274.9±98.9)×10~9/L比(218.9±65.1)×10~9/L,t=2.937,P<0.05]有明显差异。颈内动脉系统(颈总动脉分叉至大脑中动脉M1段)重度狭窄(≥70%)患者MES阳性率(22/81,27.2%)较轻中度狭窄(<70%)患者(5/101,5.0%)高(χ~2=18.698;P=0.000)。平均随访时间11.2个月(1~22个月)。总计发生缺血性脑卒中10例,其中3例TIA。MES阳性组缺血性卒中发生率18.5%(5/27),MES阴性组缺血性卒中发生率3.2%(5/155)。通过卡普兰—迈耶分析发现MES阳性组较阴性组发生缺血性脑卒中风险高(log rank=18.675,P=0.000)。结论 MES与高密度脂蛋白、血小板数量及颈动脉狭窄程度相关;MES阳性组缺血性脑卒中发生率较阴性组明显升高。
Objective This study was to investigate the value of MES combined with ESRS in prediction of ischemic stroke in asymptomatic patients. As well as the related factors that affect MES. Methods A total of 182 patients with ESRS≥3 were enrolled in this study. All patients underwent MES monitoring and follow-up. Results 182 patients had MES positive in 27 cases (14.8%). (0.96 ± 0.21) mmol / L (1.06 ± 0.24) mmol / L, t = 2.616, P <0.05] and platelet count [(274.9 ± 98.9) × 10 ~ 9 / L ratio (218.9 ± 65.1) × 10 ~ 9 / L, t = 2.937, P <0.05]. The MES positive rate (22/81, 27.2%) in patients with severe stenosis (≥70%) in the carotid artery system (carotid bifurcation to the middle cerebral artery M1 segment) was significantly lower than that in mild to moderate stenosis (<70% 101,5.0%) (χ ~ 2 = 18.698; P = 0.000). The mean follow-up time was 11.2 months (range 1-22 months). A total of 10 ischemic stroke occurred, of which 3 cases of TIA. The incidence of ischemic stroke was 18.5% (5/27) in MES positive group and 3.2% (5/155) in MES negative group. Kaplan-Meier analysis found that MES-positive patients had a higher risk of ischemic stroke than those who were negative (log rank = 18.675, P = 0.000). Conclusions MES is associated with high density lipoprotein, the number of platelets and the degree of carotid stenosis. The incidence of ischemic stroke in MES positive group is significantly higher than that in negative group.