探讨颈动脉彩色多普勒超声（color doppler ultrasound，CDUS）联合经颅彩色多普勒超声（transcranial color coded sonography，TCCS）评估缺血性脑卒中疗效的临床价值。

回顾性分析海南医学院第一附属医院神经内科在2020年3月至2021年5月收治的100例缺血性脑卒中患者的临床资料，患者均给予规范治疗，并在治疗后3个月时行CDUS、TCCS评估疗效，并经数字减影血管造影（digital subtraction angiography，DSA）证实。分析CDUS联合TCCS对缺血性脑卒中疗效的评估价值。

经治疗后患者大脑中动脉、颈内动脉终末段、大脑前动脉的收缩期峰值流速（peak systolic velocity，PSV）、舒张末期流速（end diastolic velocity，EDV）、搏动指数（pulsatility index，PI）均明显高于治疗前，阻力指数（resistance index，RI）低于治疗前；基底动脉的PSV、EDV、PI、RI均明显低于治疗前，差异均有统计学意义（P均＜0.05）；且患者颅内动脉重度狭窄占比明显低于治疗前，轻度狭窄占比明显高于治疗前，差异有统计学意义（P＜0.05）。治疗后患者颈动脉的PSV、EDV、PI和RI相比治疗前均明显降低，差异均有统计学意义（P均＜0.05）；且患者颈动脉重度狭窄占比明显低于治疗前，轻度狭窄占比明显高于治疗前，差异有统计学意义（P＜0.05）。ROC曲线结果显示，单一CDUS评估缺血性脑卒中疗效的AUC为0.794（95%CI：0.701~0.826），敏感度为78.52%，特异度为73.31%；单一TCCS评估缺血性脑卒中疗效的AUC为0.726（95%CI：0.611~0.786），敏感度为74.37%，特异度为71.01%。两者联合评估缺血性脑卒中疗效的AUC为0.945（95%CI：0.815~0.982），敏感度为96.51%，特异度为97.88%。

CDUS联合TCCS对缺血性脑卒中治疗效果的评估效能与DSA相当，可作为患者治疗后随访筛查的有效手段之一。

To assess the clinical value of carotid artery color Doppler ultrasonography (CDUS) combined with transcranial color coded sonography (TCCS) in evaluating therapeutic efficacy for ischemic stroke.

The clinical data of 100 patients with ischemic stroke admitted to the Department of Neurology of the First Affiliated Hospital of Hainan Medical College from March 2020 to May 2021 were selected and given standard treatment. CDUS and TCCS were performed 3 months after treatment to assess the efficacy, which was confirmed by digital subtraction angiography (DSA) to evaluate the value of CDUS combined with TCCS in assessing therapeutic efficacy for ischemic stroke.

The peak systolic velocity (PSV), end diastolic velocity (EDV), and pulsatility index (PI) of the middle cerebral artery, the terminal segment of the internal carotid artery, and the anterior cerebral artery after treatment were significantly higher, and the resistance index (RI) after treatment was significantly lower than those before treatment (P＜0.05 for all). The PSV, EDV, PI, and RI of the basilar artery after treatment were significantly lower than those before treatment (P＜0.05 for all). The proportion of severe intracranial artery stenosis after treatment was significantly lower and the proportion of mild stenosis was significantly higher than those before treatment (P＜0.05 for both). The PSV, EDV, PI, and RI of the carotid artery after treatment were significantly lower than those before treatment (P＜0.05 for all). The proportion of severe carotid stenosis after treatment was significantly lower and the proportion of mild stenosis was significantly higher than those before treatment (P＜0.05 for both). ROC curve analysis showed that area of the ROC curve (AUC) of CDUS alone to evaluate the efficacy of ischemic stroke was 0.794 (95%CI: 0.701~0.826), with a sensitivity of 78.52% and specificity of 73.31%. The AUC of TCCS alone for evaluating the efficacy of ischemic stroke was 0.726 (95%CI: 0.611~0.786), and the sensitivity and specificity were 74.37% and 71.01%, respectively. The AUC of the two modalities combined for evaluating the efficacy of ischemic stroke was 0.945 (95%CI: 0.815~0.982), with a sensitivity of 96.51% and specificity of 97.88%.

The efficiency of CDUS combined with TCCS in assessing therapeutic efficacy for ischemic stroke is comparable to that of DSA, and the combination can be used as one of the effective means for follow-up screening of patients after treatment.