人颈动脉粥样硬化斑块炎性反应与外周血血小板、淋巴细胞计数比值及玻璃样变性的相关性研究

Correlation between inflammatory response and peripheral blood platelet-lymphocyte ratio and vitelliform degeneration in human carotid atherosclerotic plaques

目的探讨人颈动脉粥样硬化斑块中炎性反应与外周血血小板、淋巴细胞计数比值(platelet to lymphocyte ratio,PLR)及玻璃样变性的相关性,为进一步诊治动脉粥样硬化提供新的依据。方法回顾性连续纳入2018年10月-2022年4月于南京医科大学第二附属医院神经外科接受颈动脉内膜切除术(carotid endarterectomy,CEA)治疗的颈内动脉系统粥样硬化患者39例。将切除的39个颈动脉粥样硬化斑块标本进行组织病理检测,根据斑块有无炎性反应将患者分为炎性反应组(23例)及非炎性反应组(16例),并统计玻璃样变性例数,记录患者外周血淋巴细胞计数、血小板计数,计算PLR等血液常规检查指标,分析颈动脉粥样硬化中炎性反应与PLR及玻璃样变性的相关性。结果共纳入39例患者,其中23例颈动脉粥样硬化斑块有炎性反应,32例有玻璃样变性。2组一般资料相比,炎性反应组PLR值[135.93(124.24,169.15)]较非炎性反应组PLR值[112.53(101.95,123.39)]明显升高,差异有统计学意义(P=0.002);且斑块炎性反应与玻璃样变性差异有统计学意义(P=0.035)。结论在颈动脉粥样硬化中,PLR在斑块炎性反应较重的患者中升高,且斑块内炎症反应与斑块玻璃样变性差异有统计学意义,因此检测患者血PLR值,监测斑块内炎症反应与斑块玻璃样变性两者水平变化,有助于为临床诊治和预防动脉粥样硬化提供新的依据。

Objective To investigate the correlation between inflammatory response and peripheral blood platelet-lymphocyte ratio(PLR)and vitreous degeneration in human carotid atherosclerotic plaques,and to provide a new basis for further diagnosis and treatment of atherosclerosis.Methods Thirty-nine patients with atherosclerosis of the internal carotid artery system treated by carotid endarterectomy in the Department of Neurosurgery,the Second Affiliated Hospital of Nanjing Medical University from October 2018 to April 2022 were retrospectively and consecutively included.The 39 resected carotid atherosclerotic plaque specimens were examined by histopathology,and the patients were divided into inflammatory response group and non-inflammatory response group,and vitreous degeneration and non-vitreous degeneration groups,and the patients'peripheral blood lymphocyte and platelet counts were recorded,and routine blood examination indices such as PLR were calculated to analyze the relationship between the inflammatory response in carotid atherosclerosis and PLR and the degree of vitreous degeneration.Results A total of 39 patients were included,including 23 patients with carotid atherosclerotic plaque with inflammatory response and 32 patients with hyaline degeneration.Compared with the general information for the non-inflammatory response group,the PLR value of the inflammatory response group[135.93(124.24,169.15)]was significantly higher than that of the non-inflammatory response group[112.53(101.95,123.39)],and the difference between the two groups was statistically significant(P=0.002);the difference between plaque inflammatory response and hyaline degeneration is statistically significant(P=0.035).Conclusion In carotid atherosclerosis,the PLR is increased in patients with high plaque inflammatory response,and there is a positive correlation between intraplaque inflammatory response and plaque vitreous degeneration.Therefore,measuring PLR levels in patients'blood and monitoring changes in both intraplaque inflammatory response and plaque vitreous degeneration levels may provide a new basis for clinical diagnosis,treatment and prevention of atherosclerosis.