超声造影评价恩度对颈动脉软斑块内新生血管的影响  

Evaluation of the effect of endostatin on neovascularization in the carotid soft plaques in patients with small cell lung cancer using contrast-enhanced ultrasound

作　　者：张超[1] 黄品同[1] 莫国强[1] 张莹[1] 葛丹[1] 胡宪八[1] 王尧[1] 张建民[2] 郑宁[3] 游向东[1] 刘学明[1] 

机构地区：[1]浙江大学医学院附属第二医院超声科,杭州310009 [2]浙江大学医学院附属第二医院神经外科 [3]浙江省金华市人民医院超声科

出　　处：《中华超声影像学杂志》2014年第1期20-23,共4页Chinese Journal of Ultrasonography

基　　金：基金项目：浙江省自然科学基金（Y2080718）;浙江省科技厅面上项目（2008C33012）;浙江省卫生厅省部共建计划（WKJ2011-2-007）;浙江省医药科技计划（2012KYA180）

摘　　要：目的运用超声造影技术评价恩度对颈动脉软斑内新生血管的影响。方法62例非小细胞肺癌伴颈动脉软斑块患者，按照治疗方案的不同分为长春瑞滨＋顺铂（NP）方案治疗组43例和恩度＋长春瑞滨＋顺铂（ENP）治疗组19例，同期选择不接受任何治疗的34例颈动脉软斑患者作为对照组。分别于治疗前及治疗后3个月对颈动脉软斑进行超声造影检查及声学定量分析，记录造影剂峰值强度（PI）、基础强度（BI）等参数，计算造影增强强度（EI，EI=PI—BI），并进行比较。结果三组间总胆固醇、甘油三脂、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血糖在治疗前及治疗后比较差异均无统计学意义（P〉0．05）；三组间颈动脉软斑块厚度及斑块内EI值在治疗前差异无统计学意义（P〉0．05）；治疗后3个月，三组各项实验室指标及斑块厚度分别与治疗前比较差异均无统计学意义（P〉0．05）；ENP组的EI值明显低于治疗前，差异有统计学意义（t=-3．259，P=0．002），其他两组EI值下降不明显，与治疗前比较差异无统计学意义（P〉0．05）；治疗后ENP组EI值较其他两组显著减低，差异有统计学意义（F=6．758，P=0．002）。结论恩度治疗后短期内能抑制颈动脉斑块内新生血管的生长，对斑块的稳定可能会有积极作用。Objective To investigate the therapeutic effect of endostatin on neovascularization in the carotid soft plaques in patients with non-small cell lung cancer using contrast-enhanced ultrasound（CEUS）. Methods 62 patients with small cell lung cancer were enrolled in this study from January 2007 to March 2013. All the patients with soft carotid atherosclerotic plaques were divided into two groups randomly： vinorelbine ＋ cisplatin（NP） regimen group （group A,43 cases）, and endostatin ＋ NP（ENP） regimen group （group B, 19 cases）. 34 cases with carotid plaque without non-small cell lung cancer were recruited as control group. The same soft carotid plaque in each patient was examined before and after 3-monthsp treatment respectively using CEUS. Tb.e parameters of CEUS obtained by autotracking contrast quantification（ACQ） software were compared between before and after treatment,including arrived time （AT） ,time to peak（TTP）, peak intensity（PI）, based intensity（BI） and enhanced intensity（EI, EI = PI- BI）. Results There were no significant difference of TC,TG, LDL, HDL, fasting blood glucose（FBG） and thickness of plaque（TP） among three groups before and after three month treatment. EI of carotid plaques in group A was decreased significantly （ P 〈0.05） after three month ENP regimen. While EI in control group and group B had no significant difference between pre-therapy and post-treatment（ P〈0.05）. EI of carotid plaques in group A was significantly lower （ P 〈0.05） compared with group B and control group after three month treatment （F = 6. 758, P = 0. 002）. Conclusions Endostatin could inhibit neovascularization in soft carotid plaques after 3-months＇ treatment of a ENP regimen, which may be helpful for plaque to be stable

关 键 词：超声检查 微气泡 颈动脉疾病 内皮抑素类 

分 类 号：R445.1[医药卫生—影像医学与核医学]