脑卒中患者经颅超声造影定量参数分析颈动脉斑块内新生血管与外周血白细胞分类计数及血脂的相关性研究

Study on the correlation between neovascularization and peripheral blood leukocyte counts and blood lipids in carotid plaques by quantitative analysis of transcranial ultrasound contrast in stroke patients

目的探讨脑卒中患者经颅超声造影定量参数分析颈动脉斑块内新生血管与外周血白细胞分类计数及血脂的相关性。方法选取2016-02-2019-02郑州大学第二附属医院脑卒中伴颈动脉斑块患者60例作为观察组,另选取同期60例无临床脑卒中表现的颈动脉粥样硬化斑块患者作为对照组,均采用经颅超声造影检查,对比2组外周血白细胞分类计数、血脂[低密度脂蛋白(LDL)、总胆固醇(TC)、三酰甘油(TG)及高密度脂蛋白(HDL)]及经颅超声造影定量参数[峰值强度比值(P)、达峰时间(Tp)、曲线下面积(AUC)、平均渡越时间(MTT)],并分析经颅超声造影定量参数与外周血白细胞分类计数、血脂的相关性。结果观察组总白细胞计数及中性粒细胞计数高于对照组,差异有统计学意义(P<0.05);观察组TC、TG、LDL水平高于对照组,差异有统计学意义(P<0.05);观察组P、AUC高于对照组,Tp、MTT低于对照组,差异有统计学意义(P<0.05);TG与P、AUC呈明显正相关,与Tp、MTT呈明显负相关(P<0.05);LDL与P、AUC呈明显正相关(P<0.05);中性粒细胞计数与AUC呈明显正相关(P<0.05)。结论脑卒中患者血脂水平明显增高,且存在炎症反应,经颅超声造影定量参数明显异常,且超声造影定量参数与TG、LDL、中性粒细胞计数呈明显相关性,经颅超声造影定量参数分析利于可更为客观地评价斑块稳定性。

Objective To investigate the correlation between neovascularization in carotid plaque and peripheral leukocyte count and blood lipid in stroke patients by quantitative parameters of transcranial contrast-enhanced ultrasound.Methods From February 2016 to February 2019,60 patients with cerebral apoplexy and carotid plaque in our hospital were selected as observation group,and 60 patients with carotid atherosclerosis plaque without clinical cerebral apoplexy in the same period were selected as control group.All patients were examined by transcranial contrast-enhanced ultrasonography.The peripheral blood leucocyte count,blood lipid[low density lipoprotein(LDL),total cholesterol(TC),triglyceride Acyl glycerol(TG) and high density lipoprotein(HDL) as well as quantitative parameters of transcranial contrast-enhanced ultrasound(CEUS)[peak intensity ratio(P),peak time(Tp),area under curve(AUC),mean transit time(MTT)]were compared between the two groups.,and the correlation between quantitative parameters of CEUS and peripheral leukocyte count,blood lipid were analyzed.Results The total white blood cell count and neutrophil count in the observation group were higher than those in the control group(P<0.05);the levels of TC,TG and LDL in the observation group were higher than those in the control group(P<0.05);P and AUC in the observation group were higher than those in the control group,while Tp and MTT in the observation group were lower than those in the control group(P<0.05);TG was positively correlated with P and AUC,and with Tp and MT.T was negatively correlated(P<0.05);LDL was positively correlated with P and AUC(P<0.05);neutrophil count was positively correlated with AUC(P<0.05).Conclusion The level of blood lipid in patients with stroke is significantly increased,and there are inflammatory reactions.Quantitative parameters of transcranial contrast-enhanced ultrasound are obviously abnormal.Quantitative parameters of contrast-enhanced ultrasound are significantly correlated with TG,LDL and neutrophil count.Quantitative parameters analysis of transcranial contrast-enhanced ultrasound is helpful to evaluate plaque stability more objectively.