超声造影时间-强度曲线分析冠心病患者颈动脉斑块内新生血管与高同型半胱氨酸的关系

Relationship between carotid atherosclerotic plaques neovascularization and high homocysteine in patients with coronary artery disease analyzed by time-intensity curve of contrast-enhanced ultrasound

目的通过超声造影时间-强度曲线量化分析冠状动脉粥样硬化性心脏病(CAD)患者颈动脉斑块内新生血管,探讨斑块稳定性与高同型半胱氨酸(Hcy)的关系。方法选取该院就诊的87例CAD患者分为两组:CAD合并Hcy组(合并组,45例),CAD组(42例),所有患者均行常规颈动脉超声检查,对其中75例有颈动脉斑块患者行超声造影检查,采用SonoLiver声学定量软件测量斑块达峰时间(TTP)、最大峰值强度比(IMAX%)、曲线下面积(AUC),并进行组间比较,量化分析CAD患者颈动脉斑块稳定性与Hcy的相关关系。结果合并组斑块发生率及软斑个数较CAD组高,差异有统计学意义(P<0.05);两组间斑块TTP、IMAX%、AUC进行比较,差异均有统计学意义(P<0.05)。结论超声造影时间-强度曲线可对CAD患者颈动脉斑块内新生血管分布及斑块稳定性进行量化评价,斑块不稳定性和Hcy是CAD发生、发展的高危因素。

Objective To explore the correlation between plaque stability and high homocysteine(Hcy)in patients with coronary artery disease(CAD),with quantitative analysis of carotid atherosclerotic plaques neovascularization by time-intensity curve of contrast-enhanced ultrasound.Methods 87 patients with CAD in our hospital were divided into two groups:the CAD combined with Hcy group(45 patients),and the CAD group(42 patients).All patients were observed by carotid ultrasound.Among them,75 patients with carotid atherosclerosis were observed through real-time contrast-enhanced ultrasound.Time to peak(TTP),the ratio of maximum intensity(IMAX%)and area under the curve(AUC)of carotid plaques were calculated with SonoLiver analysis software.The relationship between plaque stability and Hcy in patients with CAD was analyzed accordingly.Results The plaque incidence and the number of soft plaque in the CAD combined with Hcy group were higher than that in the CAD group(P<0.05).TTP,the ratio of IMAX,and AUC were compared respectively and showed statistical differences(P<0.05).Conclusion Time-intensity curve of contrast-enhanced ultrasound can be used to quantitate the carotid atherosclerosis plaque neovascularization and evaluate the plaque stability.The high incidence and instability of plaque in CAD combined with Hcy patients were higher than CAD patients,which sufficiently demonstrates instability of plaque and Hcy as the risk factors in CAD occurrence and development.