摘要
目的以彩色多普勒超声(CDFI)和宝石能谱CT(GSI)对颈动脉斑块进行筛选,对斑块成分进行能谱分析和斑块内钙脂相对含量定量测定,探讨血清高迁移率族蛋白1(HMGB1)、超敏C反应蛋白(Hs-CRP)在动脉粥样硬化(AS)斑块易损性中的作用。方法选择CDFI筛查有颈部动脉斑块患者100例,进一步行GSI确诊有斑块患者为病例组(49例),再经能谱评价(斑块成分的钙脂含量比值)后将其分为不稳定斑块组(21例)和稳定斑块组(28例)。另选择经GSI确诊无斑块患者20例为对照组。留取3组研究对象血清标本,采用免疫学方法测定HMGB1和Hs-CRP水平。结果不稳定斑块组Hs-CRP水平高于稳定斑块组和对照组(P<0.001),稳定斑块组Hs-CRP水平高于对照组(P<0.001)。病例组HMGB1水平高于对照组(P<0.001),不稳定斑块组HMGB1水平高于稳定斑块组(P=0.163 3)。不稳定斑块组钙脂配对浓度低于稳定斑块组(P<0.001)。HMGB1与钙脂配对浓度无显著相关性,HMGB1与Hs-CRP呈正相关,Hs-CRP与钙脂配对浓度呈负相关。结论 GSI是评价颈动脉AS斑块的新手段,可定量、定性分析斑块内成分;Hs-CRP可能与AS的发生、发展有关,且升高的Hs-CRP与斑块不稳定有关。HMGB1可能参与斑块形成过程;HMGB1与Hs-CRP共同参与AS炎症损害过程。
Aim To screen on the carotid plaque with color Doppler flow imaging（CDFI）, to analyze energy spectrum and determine the quantitative of calcium and lipid content ratio on the plaque by gemstone spectral imaging（GSI）,and explore the effect of serum HMGB1, Hs-CRP in the role of plaquevulnerability. Methods 100 patients with carotid artery plaques were selected from CDFI, and 49 patients with confirmed plaques were further diagnosed by GSI. These 49 patients were divided into a unstable plaque group（21 cases） and a steady plaque group（28 cases） through energy spectrum analysis. Later, the relative content of calcium on lipid of 49 case group patients was measured. 20 patients with normal carotid artery by GSI was the matched group. All the 69 patients were left serum sample,HMGB1 concentration and Hs-CRP concentration in serum were measured by immunoassay. Results The serum Hs-CRP level of the unstable plaque group was higher than that of the stable plaque group and the normal control group（P〈0.001）. The serum Hs-CRP level of stable plaque group was higher than that of the normal control group（P〈0.001）. The serum HMGB1 level of unstable plaque group and stable plaque group was higher than that of the normal control group（P〈0.001）. The serum HMGB1 level of the unstable plaque group was higher than that of the stable plaque group, no statistically significant difference（P=0.163 3）. The intraplaque calcium and lipid pairing concentrations of the unstable plaque group was lower than that of the stable plaque group（P〈0.001）. Serum HMGB1 and intraplaque calcium and lipid pairing concentrations were not related. Serum HMGB1 was positively associated with serum Hs-CRP. Serum Hs-CRP was negatively correlated with intraplaque calcium and lipid pairing concentrations. Conclusion Gemstone spectral imaging is a new method to study carotid atherosclerotic plaque, which can analyze plaque composition quantitatively. The serum levels of Hs-CRP may be related to the pathogenesis of atheros
出处
《中国临床神经科学》
2015年第5期488-496,共9页
Chinese Journal of Clinical Neurosciences
基金
山西省卫生厅科研课题(编号:201301011)
关键词
斑块易损性
彩色多普勒超声
宝石能谱CT
颈动脉粥样硬化斑块
超敏C反应蛋白
高迁移率族蛋白1
plaque vulnerability
color Doppler flow imaging
gemstone spectral imaging
carotid atherosclerosis plaque
hypersensitive C-reactive protein
high mobility group box-1 protein
