摘要
目的联合应用对比增强超声评估颈动脉斑块内的新生血管及高敏感性C反应蛋白(hs-CRP)检测评估急性脑梗死(CI)患者颈动脉的炎症反应。方法将2019年1—5月北部战区总医院收治的34例伴有同侧颈动脉粥样硬化斑块的急性CI患者设为CI组,将同期来院就诊的49例从未出现CI症状的患者设为非CI组。所有受试者均有颈动脉粥样硬化斑块,应用颈动脉超声将斑块分为软斑块、硬斑块和混合斑块。对斑块进行超声造影定量分析,并测定hs-CRP水平。比较CI组与非CI组以及CI组中不同斑块类型的斑块增强率、颈动脉斑块峰值强度比、曲线下面积(AUC)及峰值时间。采用Spearman相关检验评价对比参数与hs-CRP之间的相关性。结果CI组患者的斑块增强率、颈动脉斑块峰值强度比、AUC均明显高于非CI组,峰值时间短于CI组,组间比较,差异均有统计学意义(P<0.05)。CI组患者中,软斑块的斑块增强率、峰值强度比、AUC明显高于混合斑块和硬斑块,峰值时间明显短于混合斑块和硬斑块,组间比较,差异有统计学意义(P<0.05)。CI组增强斑块的hs-CRP水平明显高于非增强斑块,差异有统计学意义(P<0.05)。在CI组患者中,峰值强度比与hs-CRP水平相关性最好(r=0.77,P=0.023);AUC与hs-CRP水平密切相关(r=0.67,P=0.043);峰值时间与hs-CRP水平相关性差(r=0.17,P=0.037)。结论CI患者颈动脉不同类型斑块存在不同程度的超声造影增强和炎症反应影像学表现。超声造影增强及hs-CRP可用于检测与分析斑块危险分层。
Objective To evaluate the angiogenesis in carotid plaques and the high-sensitivity C-reactive protein(hs-CRP)assay to evaluate the inflammation of carotid arteries in patients with acute cerebral infarction(CI)by contrast-enhanced ultrasound.Methods A total of 34 acute CI patients with ipilateral carotid atherosclerosis plaques who were admitted from January to May 2019 were assigned to the CI group,and 49 patients who were admitted during the same period without CI symptoms were assigned to the non-CI group.All subjects had carotid atherosclerotic plaque,which was divided into soft plaque,hard plaque and mixed plaque by carotid ultrasound.The plaque was quantitatively analyzed by contrast-enhanced ultrasound and the hS-CRP level was determined.Plaque enhancement rate,carotid plaque peak intensity ratio,area under curve(AUC),and peak time of different plaque types were compared between CI group and non-CI group and CI group.Spearman correlation test was used to evaluate the correlation between the parameters and hs-CRP.Results The plaque enhancement rate,carotid artery plaque peak intensity ratio and AUC in the CI group were significantly higher than those in the non-CI group,and the peak time was shorter than that in the CI group,with statistically significant differences(P<0.05).In CI group,the plaque enhancement rate,peak intensity ratio and AUC of soft patches were significantly higher than that of mixed patches and hard patches,and the peak time was significantly shorter than that of mixed patches and hard patches(P<0.05).The hs-CRP level of enhanced plaques in CI group was significantly higher than that of non-enhanced plaques(P<0.05).In the CI group,the peak intensity ratio had the best correlation with hs-CRP level(r=0.77,P=0.023).AUC was closely correlated with hs-CRP level(r=0.67,P=0.043).The correlation between peak time and hs-CRP level was poor(r=0.17,P=0.037).Conclusion Different types of carotid artery plaques in patients with acute cerebral infarction showed different degrees of contrast-enhanced
作者
王萌
吴鸿莉
曹军英
刘聪
刘雨宁
牟泳霖
于馨
WANG Meng;WU Hong-li;CAO Jun-ying;LIU Cong;LIU Yu-ning;MU Yong-lin;YU Xin(Postgraduate Training Base,General Hospital of Northern Theater Command,Jinzhou Medical University,Shenyang 110016,China;Department of Special Diagnosis,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《临床军医杂志》
CAS
2020年第9期1008-1011,1014,共5页
Clinical Journal of Medical Officers
关键词
急性脑梗死
超声造影
动脉粥样硬化
超敏C反应蛋白
Acute cerebral infarction
Ultrasound-enhanced imaging
Atherosclerosis
High sensitive C reaction protein
