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目的以彩色多普勒超声(CDFI)和宝石能谱CT(GSI)对颈动脉斑块进行筛选,对斑块成分进行能谱分析和斑块内钙脂相对含量定量测定,探讨血清高迁移率族蛋白1(HMGB1)、超敏C反应蛋白(Hs-CRP)在动脉粥样硬化(AS)斑块易损性中的作用。方法选择CDFI筛查有颈部动脉斑块患者100例,进一步行GSI确诊有斑块患者为病例组(49例),再经能谱评价(斑块成分的钙脂含量比值)后将其分为不稳定斑块组(21例)和稳定斑块组(28例)。另选择经GSI确诊无斑块患者20例为对照组。留取3组研究对象血清标本,采用免疫学方法测定HMGB1和Hs-CRP水平。结果不稳定斑块组Hs-CRP水平高于稳定斑块组和对照组(P<0.001),稳定斑块组Hs-CRP水平高于对照组(P<0.001)。病例组HMGB1水平高于对照组(P<0.001),不稳定斑块组HMGB1水平高于稳定斑块组(P=0.163 3)。不稳定斑块组钙脂配对浓度低于稳定斑块组(P<0.001)。HMGB1与钙脂配对浓度无显著相关性,HMGB1与Hs-CRP呈正相关,Hs-CRP与钙脂配对浓度呈负相关。结论 GSI是评价颈动脉AS斑块的新手段,可定量、定性分析斑块内成分;Hs-CRP可能与AS的发生、发展有关,且升高的Hs-CRP与斑块不稳定有关。HMGB1可能参与斑块形成过程;HMGB1与Hs-CRP共同参与AS炎症损害过程。
Objective To screen carotid plaques by color Doppler ultrasound (CDFI) and gelspectroscopy CT (GSI), analyze the energy spectrum of the plaque and quantify the relative content of intrahepatic plaque, and investigate the relationship between the high serum mobility (HMGB1) and hypersensitive C-reactive protein (Hs-CRP) in the plaque vulnerability of atherosclerosis (AS). Methods A total of 100 patients with plaque in the neck were screened by CDFI. Forty-nine patients with plaque diagnosed by GSI were further divided into two groups according to the EDS (Calcium content of plaque component) Unstable plaque group (21 cases) and stable plaque group (28 cases). Another 20 patients with plaque confirmed by GSI were selected as the control group. Serum samples were collected from three groups of subjects and the levels of HMGB1 and Hs-CRP were determined by immunological methods. Results The level of Hs-CRP in unstable plaque group was higher than that in stable plaque group and control group (P <0.001). Hs-CRP level in stable plaque group was higher than that in control group (P <0.001). The level of HMGB1 in case group was higher than that in control group (P <0.001). The level of HMGB1 in unstable plaque group was higher than that in stable plaque group (P = 0.163 3). The concentration of calcium and lipid in the unstable plaque group was lower than that in the stable plaque group (P <0.001). There was no significant correlation between the concentration of HMGB1 and the concentration of calcium-lipid, the correlation between HMGB1 and Hs-CRP, and the negative correlation between Hs-CRP and the concentration of calcium-lipid. Conclusions GSI is a new method to evaluate carotid artery AS plaque, which can quantitatively and qualitatively analyze plaque components. Hs-CRP may be related to the occurrence and development of AS, and elevated Hs-CRP is related to plaque instability. HMGB1 may be involved in the process of plaque formation; HMGB1 and Hs-CRP participate in the process of AS inflammation.