颈动脉血管超声联合血浆Lp-PLA2判断颈动脉狭窄患者斑块状态的价值

Value of carotid artery ultrasound combined with plasma Lp-PLA2 concentration to judge plaque status in patients with carotid stenosis

目的探讨颈动脉血管超声联合血浆脂蛋白相关磷脂酶A2(Lp-PLA2)在颈动脉狭窄诊断中的价值。方法选取2021-01—2022-01在中国人民解放军联勤保障部队第960医院接受颈动脉内膜剥脱术治疗的颈动脉狭窄患者78例作为研究对象,根据病理检查明确的斑块性质,分为易损斑块(37例)组和稳定斑块(41例)组,均给予颈动脉血管超声检查,并检测血浆Lp-PLA2水平。结果易损斑块患者血浆Lp-PLA2水平(281.12±40.20)g/L,明显高于稳定斑块患者的(241.32±38.83)g/L(P<0.05)。血浆Lp-PLA2判断易损斑块的ROC曲线下面积为0.797,截断值为265.70g/L,灵敏度和特异度分别为70.30%和80.50%。颈动脉血管超声联合血浆Lp-PLA2判断易损斑块曲线下面积为0.839,明显高于颈动脉血管超声(P<0.05)。结论在颈动脉狭窄患者中,颈动脉血管超声联合血浆Lp-PLA2判断颈动脉易损斑块方面有较高的诊断价值,值得临床使用。

Objective To explore the value of carotid artery ultrasound combined with plasma lipoprotein as⁃sociated phospholipase A2(Lp-PLA2)in the diagnosis of carotid artery stenosis.Methods A total of 78 patients with carotid artery stenosis who underwent carotid endarterectomy at the 960th Hospital of the Joint Support Force of the Chinese People's Liberation Army from January 2021 to January 2022 were selected as the study subjects.According to the nature of the plaque identified by pathological examination,they were divided into vulnerable plaque(37 cases)group and stable plaque(41 cases)group.Both patients were given carotid artery ultrasound examination and their plasma Lp-PLA2 levels were measured.Results The plasma level of Lp-PLA2 in patients with vulnerable plaque(281.12±40.20)g/L was significantly higher than that in patients with stable plaque(241.32±38.83)g/L(P<0.05).The area under the ROC curve of plasma Lp-PLA2 to determine vulnerable plaque was 0.797,the cutoff value was 265.70 g/L,and the sensitivity and specificity were 70.30%and 80.50%,respectively.The area under the curve of vulnerable plaque judged by carotid artery ultrasound combined with plasma Lp-PLA2 was 0.839,significant⁃ly higher than that by carotid artery ultrasound(P<0.05).Conclusion In patients with cerebral infarction and ca⁃rotid stenosis,carotid artery ultrasound combined with plasma Lp-PLA2 has high diagnostic value in identifying vulnerable carotid plaque,which is worthy of clinical use.