Sun Runming, Wang Lixia, Guan Cuiling, Cao Wenyuan, Tian Bing
Department of Neurology, People's Hospital of Linzi District, Affiliated to Binzhou Medical College, Zibo, China.
Department of Endocrinology, People's Hospital of Linzi District, Affiliated to Binzhou Medical College, Zibo, China.
World Neurosurg. 2018 Apr;112:e223-e228. doi: 10.1016/j.wneu.2018.01.026. Epub 2018 Jan 8.
To investigate the carotid atherosclerotic plaque features in patients with acute ischemic stroke.
A total of 288 patients meeting the included criteria were enrolled and divided into an ulcerated plaque group (n = 139) and a nonulcerated plaque group (n = 149). Patients in the ulcerated plaque group were further subdivided into <50% and ≥50% stenosis groups. Carotid plaque component characteristics including luminal stenosis, carotid plaque volume, hypoechoic plaque volume, and hyperechoic plaque volume were analyzed by color Doppler ultrasound measurement. Associations between ulcerated plaque and carotid plaque features were also evaluated. The relationships among the levels of MMP-9, hs-CRP, and carotid stenosis rate were detected by enzyme-linked immunosorbent assay.
The plaque volume, hypoechoic plaque volume, and luminal stenosis in the ulcerated plaque group were higher than that of the nonulcerated plaque group (P < 0.05). Ulcerated plaque was positively associated with luminal stenosis, plaque volume, and hypoechoic plaque volume after adjusting for sex and age. The result remained similar after adjusting for age, sex, and carotid luminal stenosis. The levels of MMP-9 and hs-CRP in the ulcerated plaque group were significantly higher than those of the nonulcerated plaque group (P < 0.01). For the ulcerated plaque group, the higher the carotid stenosis rate, the higher the level of MMP-9 and hs-CRP.
Higher carotid atherosclerosis plaque volume, hypoechoic plaque volume, and luminal carotid stenosis may be symptoms of ulcerated plaque. Increased MMP-9 and hs-CRP levels could be used as adjunctive therapies of carotid stenosis at the molecular level.
探讨急性缺血性脑卒中患者的颈动脉粥样硬化斑块特征。
共纳入288例符合纳入标准的患者,分为溃疡斑块组(n = 139)和非溃疡斑块组(n = 149)。溃疡斑块组患者进一步细分为狭窄<50%组和狭窄≥50%组。通过彩色多普勒超声测量分析颈动脉斑块成分特征,包括管腔狭窄、颈动脉斑块体积、低回声斑块体积和高回声斑块体积。还评估了溃疡斑块与颈动脉斑块特征之间的关联。采用酶联免疫吸附测定法检测基质金属蛋白酶-9(MMP-9)、超敏C反应蛋白(hs-CRP)水平与颈动脉狭窄率之间的关系。
溃疡斑块组的斑块体积、低回声斑块体积和管腔狭窄程度均高于非溃疡斑块组(P < 0.05)。在调整性别和年龄后,溃疡斑块与管腔狭窄、斑块体积和低回声斑块体积呈正相关。在调整年龄、性别和颈动脉管腔狭窄后,结果仍然相似。溃疡斑块组的MMP-9和hs-CRP水平显著高于非溃疡斑块组(P < 0.01)。对于溃疡斑块组,颈动脉狭窄率越高,MMP-9和hs-CRP水平越高。
较高的颈动脉粥样硬化斑块体积、低回声斑块体积和颈动脉管腔狭窄可能是溃疡斑块的症状。MMP-9和hs-CRP水平升高可作为颈动脉狭窄分子水平的辅助治疗方法。