急性脑梗死患者颈动脉斑块内新生血管超声造影评价及其与血清YKL-40蛋白及Lp-PLA2水平的相关性分析

目的:探讨急性脑梗死(ACI)患者颈动脉斑块内新生血管超声造影的评估价值,分析其分级与患者病情严重程度、预后以及血清甲壳质酶蛋白(YKL-40)和脂蛋白相关磷脂酶A2(Lp-PLA2)水平的相关性。方法:选择2016年2月至2019年6月我院收治的102例ACI患者,进行颈动脉彩超、超声造影和血清YKL-40、Lp-PLA2检测,采用美国国立卫生院神经功能缺损评分(NIHSS)评价ACI患者病情严重程度,所有患者随访至发病后4周统计预后。结果:易损斑块组颈动脉斑块造影分级、血清YKL-40、Lp-PLA2水平高于稳定斑块组和无斑块组(P0.05)。不同病情程度组、不同预后组颈动脉斑块内新生血管造影分级均具有统计学差异(P0.05)。血清YKL-40、Lp-PLA2水平随着ACI病情程度的加重而升高(P0.05),预后不良组血清YKL-40、Lp-PLA2水平高于预后良好组(P0.05)。Spearman秩相关结果显示,颈动脉斑块内新生血管造影分级与血清YKL-40、Lp-PLA2水平均呈正相关(rs=0.751、0.694,P0.05)。结论:ACI患者的颈动脉易损斑块内新生血管超声造影分级高,其分级与病情严重程度、预后以及血清YKL-40、Lp-PLA2水平均存在密切关系,颈动脉超声造影可为ACI病情危险分层、预后判断提供有效依据。

Contrast-enhanced Ultrasonography of Intraplaque Neovascularization in Patients with Acute Cerebral Infarction and Its Correlation with Serum Ykl-40 Protein and Lp-pla2 Levels

ABSTRACT Objective: To evaluate the value of angiography in carotid artery plaque in patients with acute cerebral infarction (ACI). Analyze the correlation of intraplaque neovascularization CEUS grading with severity, prognosis, and serum levels of chitin enzymes protein-40 (YKL-40) and lipoprotein-associated phospholipase A2 (Lp-PLA2) in carotid artery plaque in patients with acute cerebral infarction (ACI). Methods: 102 patients with ACI admitted to our hospital from February 2016 to June 2019 were selected for carotid color doppler ultrasound, contrast-enhanced ultrasound and serum YKL-40, Lp-PLA2 detection. The severity of ACI was evaluated by the National Institutes of Health Stroke Scale (NIHSS), and all patients were followed up to 4 weeks after onset for statistical prognosis. Results: Intraplaque neovascularization CEUS grading, serum YKL-40, Lp-PLA2 levels in the vulnerable plaque group were higher than those in the stable plaque group and the non-plaque group (P < 0.05). The grade of angiography in carotid artery plaque in different severity group and different prognosis group had significant statistical difference (P < 0.05). Intraplaque neovascularization CEUS grading in carotid artery plaque in different severity group and different prognosis group had significant statistical difference (P < 0.05). Serum YKL-40, Lp-PLA2 levels increased with the severity of ACI (P < 0.05), and serum YKL-40,Lp-PLA2 levels in the poor prognosis group were higher than those in the good prognosis group (P< 0.05). Spearman rank correlation results showed that Intraplaque neovascularization CEUS grading in carotid plaque was positively correlated with serum YKL-40,Lp-PLA2 levels (rs=0.751, 0.694, P < 0.05). Conclusion: The grade of angiogenesis in carotid artery vulnerable plaque in ACI patients is high, which is closely related to severity, prognosis and serum YKL-40 and Lp-PLA2 levels. Carotid angiography can provide an effective basis for risk stratification and prognosis of ACI.