超声造影评估脑梗死患者颈动脉斑块内新生血管的研究

The study of intraplaque neovascularization in cerebral infarction patients with cerebral infarction detected by contrast enhanced ultrasound

目的通过超声造影评估脑血管疾病(包块颈动脉斑块合并脑梗死和颈动脉斑块无脑梗死)患者颈动脉斑块内新生血管情况,探讨颈动脉斑块内新生血管与超敏C反应蛋白(hs-CRP)的关系。方法将90例颈动脉斑块患者分为颈动脉斑块合并脑梗死患者54例,颈动脉斑块无脑梗死患者36例,所有患者均进行颈动脉超声造影。对造影后斑块的增强部分进行感兴趣区描记,与正常血管腔感兴趣区所得值进行比较,所得比值为曲线下面积比值,曲线下面积比值用来评估斑块内新生血管。结果超声造影后颈动脉斑块合并脑梗死患者曲线下面积比值高于颈动脉斑块无脑梗死患者[(0.38±0.15与0.22±0.12),P<0.05];曲线下面积比值与hs-CRP呈显著的正相关性(r=0.565,P<0.05),进一步回归分析明确了曲线下面积比值是脑梗死患者的危险因素(OR=2.400,P<0.05)。结论脑梗死患者颈动脉斑块内新生血管明显高于单纯颈动脉斑块患者,斑块内新生血管是脑梗死的危险因素,斑块内新生血管与hs-CRP水平正相关性。

Objective To evaluate the intraplaque neovascularization in the cerebrovascular diseases （carotid plaques complicat- ed with cerebral infarction and carotid artery plaque without cerebral infarction） by the contrast enhanced ultrasound （CEUS）,and to ex- plore the relationship between the intraplaque neovascularization and the high sensitive C reactive protein （ Hs - CRP）. Methods 90 cases with carotid artery plaque were collected, and divided into two groiips： carotid plaques complicated with cerebral infarction 54 patients and carotid artery plaque without cerebral infarction 36 patients. All patients underwent carotid CEUS. Enhanced part angiography plaque ROIs tracings were obtained, and calculated the average. Compared the average and the normal vessel lumen, calculated the AUC to assess the in- traplaque neovascularization. Results The AUC ratio of carotid plaques complicated with cerebral infarctions were higher than the carotid artery plaque without cerebral infarctions （ P 〈 0.05 ）. The AUC ratio was positive related with the Hs - CRP （ r = 0.565, ,P 〈 0.05 ）. The regression analysis defined the AUC ratio was the risk factor to the cerebral infarction （ OR = 2.400,P 〈 0.05）. Conclusion The intra- plaque neovascularization of the carotid plaques complicated with cerebral infarction is a risk factor for cerebral infarction. The intraplaque neovascularization is positive related with the Hs - CRP.