超敏感微血流显像技术评估颈动脉粥样硬化斑块易损性及其与脑梗死的相关性

    Study on the supersensitive microflow imaging technique in evaluating the carotid atherosclerotic plaque vulnerability and its correlation with cerebral infarction

    • 摘要:
      目的: 探讨通过超敏感微血流显像(AP)技术检测颈动脉斑块内新生血管(IPN)的形成,分析其与脑梗死发生的相关性,评估AP技术在识别易损斑块中的应用价值。
      方法: 纳入157例颈动脉粥样硬化伴斑块形成病人,其中急性脑梗死病人83例,非急性脑梗死病人74例。调查病人一般情况,通过常规超声与AP技术检查颈动脉斑块,比较2组病人在斑块大小、回声和斑块内新生血管(IPN)之间的差异。
      结果: 在157例有颈动脉斑块形成的病人中,共收集到245个斑块,其中急性脑梗死组133个,非急性脑梗死组112个,急性脑梗死组斑块长度、斑块内微血流(IMVF)等级、IPN数目均大于非急性脑梗死组(P < 0.05~P < 0.01),2组IPN频谱构成差异亦有统计学意义(P < 0.01)。多因素logistic回归分析表明IMVF等级(OR = 1.415,95%CI:1.017~1.968,P < 0.05)及IPN数目(OR = 2.863,95%CI:1.310~6.254,P < 0.01)与急性脑梗死的发生存在明显的相关性,且IMVF等级越高、IPN数目越多,斑块更易损。
      结论: 颈动脉IPN的形成即斑块的易损性可能和脑梗死的发生有关,AP技术也有望成为识别易损斑块的有效检测手段。

       

      Abstract:
      Objective To investigate the formation of neovascularization (IPN) in carotid plaque by AngioPLUS (AP) technology, analyze the correlation with cerebral infarction, and evaluate the application value of AP technology in identifying vulnerable plaques.
      Methods One hundred and fifty-seven patients with carotid atherosclerosis complicated with plaque formation (including 83 cases of acute cerebral infarction and 74 cases of non-acute cerebral infarction) were selected. The general situation of patients were investigated, the carotid artery plaque was detected by routine ultrasound and AP technique. The differences in the plaque size, echo and intraplaque neovascularization (IPN) between two groups were compared.
      Results Among the 157 patients with carotid plaque formation, 245 plaques were collected, which included133 cases in the acute cerebral infarction group and 112 cases in the non-acute cerebral infarction group. The plaque length, IMVF grade and IPN number in the acute cerebral infarction group were higher than those in non-acute cerebral infarction group (P < 0.05 to P < 0.01), and the difference of the IPN spectrum composition between two groups was statistically significant (P < 0.01). The results of logistic regression analysis showed that the IMVF grade (OR = 1.415, 95%CI: 1.017–1.968, P < 0.05) and IPN number (OR = 2.863, 95%CI: 1.310–6.254, P < 0.01) were significantly correlated with the occurrence of acute cerebral infarction, and the higher the IMVF grade and the more IPN number, the more vulnerable plaque.
      Conclusions The formation of carotid IPN, namely the vulnerability of plaque, may be related to the occurrence of cerebral infarction. AP technology is also expected to be an effective detection means to identify vulnerable plaque.

       

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