血管内超声弹性成像联合血清LP(a)、GGT对CAS斑块稳定性评估及预后预测价值分析  

Analysis of the value of intravascular ultrasound elastography combined with serum LP(a)and GGT in evaluating CAS plaque stability and predicting prognosis

作　　者：曹薇 慈丽娜 张洁 王松 CAO Wei;CI Lina;ZHANG Jie;WANG Song(Physical Examination Center,Xingtai Central Hospital,Xingtai,Hebei,China,054000;Department of Functional Sciences,Xingtai Central Hospital,Xingtai,Hebei,China,054000;Department of Neurosurgery,Xingtai Central Hospital,Xingtai,Hebei,China,054000)

机构地区：[1]邢台市中心医院体检中心,河北邢台054000 [2]邢台市中心医院功能科,河北邢台054000 [3]邢台市中心医院神经外科,河北邢台054000

出　　处：《分子诊断与治疗杂志》2025年第1期17-20,25,共5页Journal of Molecular Diagnostics and Therapy

基　　金：邢台市重点研发计划自筹项目(2023ZC104)。

摘　　要：目的本研究旨在探讨血清脂蛋白(a)[LP(a)]、γ⁃谷氨酰转肽酶(GGT)、血管内超声弹性成像(IVUSE)检查与颈动脉粥样硬化(CAS)斑块性质的相关性及对CAS预后的预测价值。方法选取2021年3月至2024年3月期间在邢台市中心医院体检中心超声室接受IVUSE检查的106例CAS患者为CAS组,90名健康体检者为健康组。CAS组根据病理学及核磁共振结果分为斑块稳定组(63例)和不稳定组(43例)。比较三组研究对象的血清LP(a)、GGT、IVUSE。根据心血管不良事件发生与否,将CAS组分为不良组(45例)和良好组(61例)。采用Pearson相关性分析血清LP(a)、GGT、IVUSE结果与CAS患者的CAS斑块性质和不良心血管事件发生的相关性。采用多因素Logistic回归分析CAS预后不良的影响因素。绘制受试者工作特征(ROC)曲线分析血清LP(a)、GGT、IVUSE对CAS预后的预测价值。结果CAS组患者血清LP(a)、GGT、IVUSE弹性积分均高于健康组,稳定组LP(a)、GGT、IVUSE弹性积分均低于不稳定组,差异有统计学意义(F=112.053、116.884、440.007,P<0.05)。Pearson相关性分析显示,血清LP(a)、GGT、IVUSE弹性积分与CAS患者CAS斑块性质和不良心血管事件发生均呈正相关性(r=0.649、0.757、0.721,0.590、0.775、0.726,P<0.05)。Logistic回归分析显示,血清LP(a)、GGT、IVUSE均为CAS预后不良的危险因素(P<0.05)。血清LP(a)、GGT、IVUSE三者单一预测的ROC曲线下面积(AUC)分别为0.875、0.962、0.939,联合预测AUC为0.997。三者联合预测CAS预后的预测价值最高,敏感度为0.934,特异度为1.000(P<0.05)。结论血清LP(a)、GGT、IVUSE联合检测对CAS有较高的预后预测价值,且三者与CAS患者的斑块性质相关。Objective To investigate the correlation between serum lipoprotein(a)[LP(a)],γ⁃glutamyl transpeptidase(GGT),and intravascular ultrasound elastography(IVUSE)examination with the plaque nature of carotid atherosclerosis(CAS)and the predictive value of prognosis of CAS.Methods One hundred and six patients with CAS who underwent IVUSE examination in the ultrasound room of Xingtai Cen⁃tral Hospital Physical Examination Centre between March 2021 and March 2024 were selected as the CAS group,and another 90 healthy individuals who had medical check⁃ups were selected as the healthy group.The CAS group was further subdivided into the plaque⁃stable group(63 cases)and the unstable group(43 cases)based on the results of pathology and magnetic resonance imaging(MRI).Serum LP(a)and GGT levels and IVUSE results,were compared among the three study groups.The CAS group was then divided into a poor prognosis group(45 cases)and a good prognosis group(61 cases)based on the occurrence or non⁃occurrence of adverse cardiovascular events.Pearson's correlation was used to analyze the relationship between serum LP(a),GGT levels,and IVUSE results,the nature of CAS plaques,and the occurrence of adverse cardiovascular events in CAS patients.Multivariate logistic regression was used to analyze the influencing factors of a poor prognosis in CAS.The predictive value of serum LP(a),GGT levels,and IVUSE results for CAS prognosis was analyzed by plotting a receiver operating characteristic(ROC)curve.Results Serum LP(a),GGT,and IVUSE elasticity scores were higher in the CAS group than in the healthy group,and lower in the stable group than in the unstable group.These differences were statistically significant(F=112.053,116.884,440.007,P<0.05).Pearson correlation analysis indicated that serum LP(a),GGT,and IVUSE results were positively correlated with the nature of CAS plaques and the occurrence of adverse cardiovascular events in pa⁃tients with CAS(r=0.649,0.757,0.721,0.590,0.775,0.726,P<0.05).Logistic regression analysis revealed that

关 键 词：颈动脉粥样硬化 脂蛋白(a) γ⁃谷氨酰转肽酶 血管内超声弹性成像 

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]