摘要
目的探讨超声造影(CEUS)联合血清标志物对不稳定斑块的诊断价值。方法选取经我院常规超声检查发现颈动脉粥样硬化斑块的患者190例(共190枚斑块),术前均行CEUS检查,检测血清脂蛋白相关磷脂酶A2(Lp-PLA2)和超敏C反应蛋白(hs-CRP)。以病理结果为金标准,根据斑块稳定性分为不稳定斑块组(138例)和稳定斑块组(52例),比较两组CEUS检查情况、血清Lp-PLA2、hs-CRP水平的差异;分析CEUS、血清标志物单独及联合诊断不稳定斑块的价值。结果CEUS诊断不稳定斑块135枚,稳定斑块55枚;不稳定斑块中CEUS增强分级Ⅰ、Ⅱ、Ⅲ级分别为7、38、93枚,稳定斑块CEUS增强分级Ⅰ、Ⅱ、Ⅲ级分别为20、28、4枚。不稳定斑块组血清hs-CRP水平为(23.17±0.53)mg/L,Lp-PLA2水平为(257.32±84.62)mg/L,均高于稳定斑块组[(16.32±0.56)mg/L]、[(185.65±61.42)mg/L],差异均有统计学意义(t=0.347、37.258,均P=0.000)。与CEUS、血清hs-CRP、Lp-PLA2水平单独及两两联合诊断比较,三者联合诊断不稳定斑块的敏感性(88.50%)、特异性(94.20%)、准确率(92.63%)均最高,差异均有统计学意义(均P<0.05)。结论CEUS联合血清hs-CRP、Lp-PLA2有助于早期诊断不稳定斑块,具有较好的临床应用价值。
Objective To explore the value of contrast-enhanced ultrasound(CEUS)combined with serum markers in the diagnosis of unstable plaques.Methods A total of 190 patients with carotid atherosclerotic plaques(totally 190 plaques)found by routine ultrasonography in our hospital were selected.Preoperative CEUS examination was performed,and serum lipoprotein associated phospholipase-A2(Lp-PLA2)and high sensitivity C-reactive protein(hs-CRP)were detected.Taking pathological results as the golden standard,the plaques were divided into unstable plaque group(138 cases)and stable plaque group(52 cases)according to plaque stability,and the differences in CEUS condition,serum Lp-PLA2 and hs-CRP levels between the two groups were compared.The efficacy of CEUS and serum markers application alone and in combination in diagnosing unstable plaques was analyzed.Results CEUS diagnosed 135 unstable plaques and 55 stable plaques,CEUS enhanced grading in unstable plaque group were 7 plaques of gradeⅠ,38 plaques of gradeⅡ,93 plaques of gradeⅢ,while 20plaques of gradeⅠ,28 plaques of gradeⅡ,4 plaques of gradeⅢin stable plaque group.Serum hs-CRP[(23.17±0.53)mg/L]and Lp-PLA2[(257.32±84.62)mg/L]in unstable plaque group were significantly higher than those in stable plaque group[(16.32±0.56)mg/L]and[(185.65±61.42)mg/L],the differences were statistically significant(t=0.347,37.258,both P=0.000).Compared with CEUS,serum hs-CRP and Lp-PLA2 levels application alone and in combination of two,the sensitivity,specificity and accuracy of the three combined in the diagnosis of unstable plaque were the highest(88.50%,94.20%,92.63%),and the differences were statistically significant(all P<0.05).Conclusion CEUS combined with serum hs-CRP and Lp-PLA2levels is helpful to early diagnosis of unstable plaque,and has good application clinical value.
作者
王辉
张强
申向辉
尹素芳
侯晓英
WANG Hui;ZHANG Qiang;SHEN Xianghui;YIN Sufang;HOU Xiaoying(Department of Ultrasound Medicine,Handan Central Hospital of Hebei Province,Hebei 056000,China)
出处
《临床超声医学杂志》
CSCD
2022年第3期227-230,共4页
Journal of Clinical Ultrasound in Medicine
基金
河北省2017年度医学科学研究重点课题计划(20171136)。
关键词
超声检查
造影剂
不稳定斑块
超敏C反应蛋白
脂蛋白相关磷脂酶-A2
Ultrasonography
Contrast agent
Unstable plaque
High sensitivity C-reactive protein
Lipoprotein associated phospholipase-A2
