Department of Radiology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China (mainland).
Department of Neurosurgery, Lianyungang Hospital of Traditional Chinese Medicine, Lianyungang, Jiangsu, China (mainland).
Med Sci Monit. 2021 Dec 3;27:e933351. doi: 10.12659/MSM.933351.
BACKGROUND We analyzed the correlation among the inflammatory changes in pericarotid adipose tissue (PCAT), plaque characteristics, and H-type hypertension on CT angiography (CTA) and explored the utility of CTA in the prevention and treatment of carotid atherosclerosis. MATERIAL AND METHODS A total of 135 patients who underwent head and neck CTA to investigate carotid artery atherosclerosis were retrospectively analyzed. The plaque characteristic parameters (plaque burden and remodeling index), PCAT attenuation value, and net enhancement value around the carotid artery, where the plaques were located, were recorded, and confounding factors were matched by propensity score analysis. A paired t test was used to compare the differences in fat tissue inflammatory changes and plaque characteristic parameters between the 2 groups, and logistic regression analysis was used to evaluate the relationship between plaque characteristics and the attenuation values and net enhancement values of PCAT. The correlation coefficient was calculated between type H hypertension and plaque risk grade. RESULTS The results of the experiment indicate that PCAT attenuation values and net enhancement values gradually increased as the degree of hypertension increased. Compared with those of patients in the normal Hcy group, these values increased more clearly in patients with high Hcy (HHcy) (r=0.641, P<0.001, r=0.581, P<0.001), although, regardless of whether the Hcy value increased, there were significant differences between the groups. However, this effect was more pronounced in patients with H-type hypertension. Logistic regression analysis of risk factors for carotid atherosclerotic plaque suggests that Hcy (OR=1.391, 95% CI 1.146-1.689, P=0.001), PCAT attenuation values (OR=1.212, 95% CI 1.074-1.367, P=0.002), and net enhancement values (OR=1.201, 95% CI 1.042-1.383, P=0.011) were independent risk factors for plaque vulnerability. CONCLUSIONS Our results suggest that H-type hypertension is significantly associated with PCAT attenuation and net enhancement and that PCAT net enhancement values are useful in predicting plaque risk as attenuation.
我们分析了颈动脉周围脂肪组织（PCAT）炎症变化、斑块特征和 H 型高血压之间的相关性，并探讨了 CT 血管造影（CTA）在颈动脉粥样硬化防治中的应用。
回顾性分析了 135 例行头颈部 CTA 检查颈动脉粥样硬化的患者。记录斑块特征参数（斑块负荷和重构指数）、颈动脉斑块部位 PCAT 衰减值和净增强值，并用倾向评分匹配法匹配混杂因素。采用配对 t 检验比较两组间脂肪组织炎症变化和斑块特征参数的差异，采用 logistic 回归分析评价斑块特征与 PCAT 衰减值和净增强值的关系。计算 H 型高血压与斑块风险分级的相关系数。
实验结果表明，PCAT 衰减值和净增强值随高血压程度的增加而逐渐增加。与正常 Hcy 组相比，高 Hcy（HHcy）组的这些值增加更为明显（r=0.641，P<0.001，r=0.581，P<0.001），尽管无论 Hcy 值是否升高，两组之间均有显著差异。然而，这种影响在 H 型高血压患者中更为明显。颈动脉粥样硬化斑块危险因素的 logistic 回归分析表明，Hcy（OR=1.391，95%CI 1.146-1.689，P=0.001）、PCAT 衰减值（OR=1.212，95%CI 1.074-1.367，P=0.002）和净增强值（OR=1.201，95%CI 1.042-1.383，P=0.011）是斑块易损性的独立危险因素。
我们的研究结果表明，H 型高血压与 PCAT 衰减和净增强显著相关，PCAT 净增强值有助于预测斑块风险。
