颈动脉斑块最大厚度值和Lp-PLA2水平与颈动脉易损斑块的相关性  

Correlation Between the Maximum Carotid Plaque Thickness,Lp-PLA2 Level and the Vulnerable Carotid Plaque in Patients

作　　者：彭佩燕 张泽鑫 吴壮雄[1] Peng Peiyan;Zhang Zexin;Wu Zhuangxiong(Department of Ultrasound,Shantou Central Hospital,Shantou 515031,China;Department of Emergency,Shantou Central Hospital,Shantou 515031,China)

机构地区：[1]汕头市中心医院超声科,汕头市515031 [2]汕头市中心医院急诊科,汕头市515031

出　　处：《中国超声医学杂志》2024年第1期16-19,共4页Chinese Journal of Ultrasound in Medicine

基　　金：汕头市医疗卫生科技计划项目(No.220430106490198)。

摘　　要：目的探讨颈动脉斑块最大厚度值和血浆脂蛋白相关磷脂酶A2(Lp-PLA2)水平与颈动脉易损斑块的相关性。方法选取确诊的急性轻中度缺血性脑卒中患者171例,根据超声结果分为无斑块组、稳定斑块组和易损斑块组,比较各组间一般临床资料、颈动脉超声参数及Lp-PLA2水平,应用多因素Logistic回归分析确定颈动脉易损斑块的独立危险因素,用受试者工作特征(ROC)曲线分析其对斑块易损性的预测价值。结果稳定和易损斑块组的高血压发病率、颈动脉斑块最大厚度值、颈动脉斑块数量≥3个的例数及Lp-PLA2水平差异均有统计学意义。多因素Logistic回归分析提示颈动脉斑块最大厚度值增加和Lp-PLA2水平升高是形成易损斑块的独立危险因素,两者单独及两者联合预测斑块易损性曲线下面积(AUC)分别为0.651、0.631、0.708。结论颈动脉斑块最大厚度值、Lp-PLA2水平与易损斑块存在较好的相关性,两者联合可更好地评估斑块的易损性,可为临床筛查及干预治疗提供有价值的理论依据。Objective To investigate the correlation between the maximum carotid plaque thickness,lipoprotein-associated phospholipase A2(Lp-PLA2)level,and the vulnerable carotid plaque.Methods A total of 171 patients diagnosed with acute mild or moderate ischemic stroke in our hospital were selected.Based on the findings of carotid ultrasound,they were classified into non-plaque,stable plaque,and vulnerable plaque groups.The groups were compared in terms of general clinical data,carotid ultrasound parameters,and Lp-PLA2 levels.The independent risk factors of vulnerable carotid plaque were determined through multivariate Logistic regression analysis,and receiver operating characteristic(ROC)curve was used to analyze its predictive value for plaque vulnerability.Results There were significant differences in the incidence of hypertension,the maximum thickness of carotid plaque,the number of carotid plaques and the level of Lp-PLA2 between the stable and vulnerable plaque groups.The increase in maximum thickness of carotid plaque and the increase in Lp-PLA2 level were independent risk factors for vulnerable plaque,as demonstrated by multivariate Logistic regression.The area under the curve(AUC)for predicting vulnerable plaque was 0.651,0.631,and 0.708 for the two alone and the combination respectively.Conclusions The maximum carotid plaque thickness and Lp-PLA2 level have a good correlation with vulnerable plaque.The combination of the two can enhance the assessment of plaque's vulnerability,which can provide a valuable theoretical basis for clinical screening and intervention treatment.

关 键 词：颈动脉斑块最大厚度 LP-PLA2 缺血性脑卒中 易损斑块 

分 类 号：R445.1[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]