多模态超声评价颈动脉斑块易损性与冠心病患者血清人可溶性配体、妊娠相关血浆蛋白A水平的相关性  

Correlation studies of carotid plaque vulnerability with coronary heart disease patients′ serum soluble CD40 ligand and pregnancy-associated plasma protein-A levels based on the multi-modal ultrasound

作　　者：黄志平[1] 吴龙燕 郭明英 林霖[1] 丁小军[1] HUANG Zhiping;WU Longyan;GUO Mingying;LIN Lin;DING Xiaojun(Ultrasonic Department,Ganzhou People's Hospital,Jiangxi Province,Ganzhou 341000,China;Ultrasound Cardiogram Department,Ganzhou Ganxian People's Hospital,Jiangxi Province,Ganzhou 341100,China)

机构地区：[1]江西省赣州市人民医院超声科,江西赣州341000 [2]江西省赣州市赣县区人民医院超声心电科,江西赣州341100

出　　处：《中国当代医药》2025年第1期71-75,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202311853)。

摘　　要：目的探讨多模态超声评价颈动脉斑块易损性与冠心病患者血清人可溶性配体(sCD40L)、妊娠相关血浆蛋白A(PAPP-A)水平的相关性。方法选取2022年5月至2023年10月赣州市人民医院资料完整的60例冠心病患者作为研究对象,行颈动脉二维超声、超微血流成像、超声造影多模态超声检查,综合评价斑块的易损性,根据斑块易损或稳定分为易损斑块组(29例)和非易损斑块组(31例),比较两组sCD40L、PAPP-A检测水平,分析研究斑块易损性与血清CD40L、PAPP-A的相关性。结果以目前颈动脉斑块解剖成像的金标准高分辨率磁共振确诊阳性、阴性例数分别为30、30例,多模态超声检查确诊阳性、阴性例数分别为29、31例(稳定性斑块患者30例,无斑块1例),多模态超声诊断准确度、灵敏度、特异度分别为95.00%、93.33%、96.67%;易损斑块组sCD40L、PAPP-A水平均高于非易损斑块组,差异有统计学意义(P<0.05);sCD40L、PAPP-A水平评判易损斑块有较高的准确性(AUC分别约0.728、0.948);颈动脉斑块易损性与sCD40L、PAPP-A水平呈正相关(P<0.05)。结论通过对冠心病患者进行颈动脉斑块多模态超声检查及实验室测定,证实颈动脉斑块易损性与sCD40L、PAPP-A存在密切相关,可预测冠心病患者冠状动脉斑块不稳定性,为临床诊断和治疗提供一定依据。Objective To analyze the correlations of carotid plaque vulnerability with coronary heart disease patient's serum soluble CD40 ligand(sCD40L)and pregnancy-associated plasma protein-A(PAPP-A)levels based on the multi-modal ultrasound.Methods A total of 60 coronary heart disease patients treated from May 2022 to October 2023 in Ganzhou People's Hospital were selected as the study objects.The carotid plaque vulnerability was evaluated through the carotid artery two-dimensional ultrasound,superb micro-vascular imaging and multi-modal contrast-enhanced ultrasound.Patients were assigned to vulnerable group(29 cases)and non-vulnerable group(31 cases).Serum sCD40L and PAPP-A levels were measured,the correlations of the carotid plaque vulnerability with serum CD40L and PAPP-A levels were analyzed.Results A total of 30 positive cases and 30 negative cases were confirmed by the high-resolution magnetic resonance imaging,29 positive cases and 31 negative cases(30 stable plaque cases and one non-plaque case)by the multi-modal ultrasound.The diagnosis accuracy,sensitivity and specificity based on the multi-modal ultrasound were 95.00%,93.33%and 96.67%.Serum sCD40L and PAPP-A levels in vulnerable group were higher than non-vulnerable group,and the differences were statistically significant(P<0.05).Upon the plaque vulnerability assessment,AUC based on sCD40L and PAPP-A were 0.728 and 0.948.The carotid plaque vulnerability was positively correlated with the serum sCD40L and PAPP-A levels(P<0.05).Conclusion The multi-modal ultrasound and laboratory detection have showed that the carotid plaque vulnerability is closely correlated with the patients'serum sCD40L and PAPP-A levels,predicting the carotid plaque instability and providing basis on the clinical diagnosis and treatment.

关 键 词：多模态超声 颈动脉斑块易损性 冠心病 人可溶性配体 妊娠相关血浆蛋白A 

分 类 号：R541.4[医药卫生—心血管疾病]