SMI技术诊断多发性大动脉炎的价值及其与血清MMP-3、MMP-9的关系  

The value of superb micro-vascular imaging technique in diagnosis of Takayasu arteritis and its relationship with serum MMP-3 and MMP-9

作　　者：陈敏 杨雅淇 高丽[1] 牛慧敏[1] 叶玉泉[1] CHEN Min;YANG Yaqi;GAO Li;NIU Huimin;YE Yuquan(Department of Ultrasound,Hebei General Hospital,Shijiazhuang,050000,China)

机构地区：[1]河北省人民医院超声科,石家庄050000

出　　处：《临床心血管病杂志》2023年第2期135-140,共6页Journal of Clinical Cardiology

摘　　要：目的:探究超微细血管成像技术(SMI)诊断多发性大动脉炎(TA)的价值及与血清基质金属蛋白酶(MMP)-3、MMP-9的关系。方法:选取2020年4月—2022年1月我院30例TA患者,根据疾病活动性分为活动期组(18例)和非活动期组(12例)。两组均行颈动脉常规超声及SMI检查,比较两组管壁厚度、颈动脉内中膜厚度(IMT)、SMI分级及血清MMP-3、MMP-9水平,分析TA患者IMT、SMI分级与血清MMP-3、MMP-9水平的相关性,探讨IMT、SMI分级诊断TA活动性的价值。活动期组经治疗处于非活动期后复查超声及SMI,比较治疗前后IMT及SMI分级。结果:活动期组IMT、SMI分级及血清MMP-9水平较非活动期组高,血清MMP-3水平较非活动期组低(均P<0.05)。TA患者IMT、SMI分级与血清MMP-3水平呈负相关,与MMP-9水平呈正相关(均P<0.05)。以活动期组为阳性样本,IMT诊断活动性TA的ROC曲线下面积(AUC)为0.646;以≥Ⅱ级作为SMI诊断活动期TA的标准,灵敏度为66.67%(12/18),特异度为100%(12/12),准确度为80.00%(24/30)。活动期组18例患者治疗3个月后均转为非活动期,治疗后IMT及SMI分级均较治疗前降低(均P<0.05)。结论:SMI分级及血清MMP-3、MMP-9水平与TA病情活动性密切相关,为临床早期评估TA活动性及疗效提供可靠依据,以针对性制定个体化治疗方案。Objective: To explore the value of superb micro-vascular imaging(SMI) in the diagnosis of Takayasu arteritis(TA) and its correlation with serum matrix metalloproteinase(MMP)-3 and MMP-9. Methods: Thirty TA patients in our hospital from April 2020 to January 2022 were selected and divided into the active period group(n=18) and the inactive period group(n=12) according to disease activity. Carotid artery conventional ultrasound and SMI examination were performed in both groups, and the wall thickness, carotid artery intima-media thickness(IMT), SMI grade, and serum MMP-3 and MMP-9 levels were compared between the two groups. The correlation of IMT and SMI grades with serum MMP-3 and MMP-9 levels, and the value of IMT and SMI grades in diagnosing TA activity were analyzed. Ultrasound and SMI were rechecked after treatment in the inactive period group, and IMT and SMI grades were compared before and after treatment. Results: IMT, SMI grade, and serum MMP-9 levels in the active period group were higher than those in the inactive period group, and serum MMP-3 level was lower than that in the inactive period group(all P<0.05). IMT and SMI grades were negatively correlated with MMP-3 level, while positively correlated with MMP-9(all P<0.05). Taking the active period group as the positive sample, the area under the ROC curve(AUC) of IMT for the diagnosis of active TA was 0.646;Taking SMI≥grade II as the standard for diagnosing active TA, the sensitivity was 66.67%(12/18), the specificity was 100%(12/12), and the accuracy was 80.00%(24/30). All patients in the active period group turned into the inactive stage, and the IMT and SMI grades after treatment were lower than those before treatment(both P<0.05). Conclusion: SMI grade, serum MMP-3 and MMP-9 levels are closely related to TA activity, which can provide a reliable basis for early clinical assessment and curative effect, so as to formulate individualized treatment plans.

关 键 词：多发性大动脉炎 超微细血管成像技术 基质金属蛋白酶 诊断 

分 类 号：R543.5[医药卫生—心血管疾病]