目的 基于颈动脉彩色超声评估颈内动脉壁面切应力（WSS）与颈动脉斑块内新生血管（IPN）的关系。 方法 选择2021年7月至2023年9月河北医科大学第一医院收治的99例明确有颈动脉粥样硬化性斑块（CAP）的缺血性脑血管病患者。所有患者均接受颈动脉彩色超声、常规超声与颈动脉超声造影（CEUS）检查，根据缺血性脑血管病患者是否形成颈动脉IPN分为形成组与非形成组。对比形成组与非形成组WSS、临床资料，分析缺血性脑血管病患者形成颈动脉IPN的影响因素，分析平均WSS对缺血性脑血管病患者形成颈动脉IPN的预测价值。 结果 99例缺血性脑血管病患者中，形成颈动脉IPN 23例，剩余76例均未形成颈动脉IPN。形成组白细胞计数、斑块厚度、斑块长度、狭窄程度≥ 70%比例、C反应蛋白、基质金属蛋白酶-9与基质金属蛋白酶组织抑制剂-1比值（MMP-9/TIMP-1）高于非形成组（P < 0.05）。Logistic回归分析结果显示，平均WSS（OR = 4.545，95%CI：1.998 ~ 10.339）、狭窄程度（OR = 2.765，95%CI：1.215 ~ 6.290）、C反应蛋白（OR = 3.047，95%CI：1.339 ~ 6.930）、MMP-9/TIMP-1（OR = 3.543，95%CI：1.558 ~ 8.060）为缺血性脑血管病患者形成颈动脉IPN的影响因素（P < 0.05）。受试者工作特征曲线（ROC）结果显示，平均WSS预测缺血性脑血管病患者形成颈动脉IPN的AUC值为0.797（P < 0.05），当平均WSS为10.23 dyne/cm²时，最大特异度与灵敏度为85.53%和78.26%。 结论 颈内动脉平均WSS在预测缺血性脑血管病患者形成颈动脉IPN中具有良好价值。

Objective To assess the correlation between wall shear stress （WSS） in the internal carotid artery and neovascularization of carotid plaque using color ultrasound imaging. Methods A total of 99 patients diagnosed with carotid atherosclerotic plaque （CAP） were prospectively selected between July 2021 and September 2023. All patients underwent comprehensive carotid imaging including color ultrasound， conventional ultrasound， and carotid contrast-enhanced ultrasound （CEUS）. Based on the presence or absence of intraplaque neovascularization （IPN） in patients with ischemic cerebrovascular disease， they were categorized into the forming group and non-forming group. Comparative analysis was performed on wall shear stress （WSS） values and clinical data between these two groups to identify factors influencing IPN formation in the carotid artery among patients with ischemic cerebrovascular disease， while also assessing the predictive value of average WSS for IPN formation. Results Among 99 patients with ischemic cerebrovascular disease， carotid artery IPN was observed in 23 cases， while the remaining 76 cases did not exhibit carotid artery IPN. The formation group demonstrated significantly higher levels of white blood cell count， plaque thickness， plaque length， stenosis ≥ 70% ratio， C?reactive protein， and matrix metalloproteinase?9 to tissue inhibitor of matrix metalloproteinase?1 （MMP?9/TIMP?1） ratio compared to the non?formation group （P < 0.05）. Logistic regression analysis revealed that mean wall shear stress （OR = 4.545； 95% CI： 1.998 ~ 10.339）， stenosis severity （OR = 2.765； 95% CI： 1.215 ~ 6.290）， C?reactive protein levels （OR = 3.047； 95% CI： 1.339 ~ 6.930）， and MMP?9/TIMP?1 ratio （OR = 3.543； 95% CI： 1.558 ~ 8.060） were significant influencing factors for carotid artery IPN formation in patients with ischemic cerebrovascular disease （P < 0.05）. The receiver operating characteristic curve （ROC） analysis revealed that the area under the curve （AUC） for average WSS in predicting carotid artery intraplaque neovascularization formation in patients with ischemic cerebrovascular disease was 0.797 （P < 0.05）. At an average WSS of 10.23 dyne/cm²， the maximum specificity and sensitivity were determined to be 85.53% and 78.26%， respectively. Conclusion The mean WSS of internal carotid artery has a good value in predicting the formation of carotid IPN in patients with ischemic cerebrovascular disease.