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颈动脉超微血管成像评估大动脉炎活动度的临床研究

Clinical study of carotid superb microvascular imaging in evaluating the activity of Takayasu's arteritis.

作者信息

Liu Feng-Ju, Ci Wei-Ping, Cheng Yi

机构信息

Department of Ultrasound, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Capital Medical University, Beijing, China.

Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Capital Medical University, Beijing, China.

出版信息

Front Cardiovasc Med. 2023 Mar 6;10:1051862. doi: 10.3389/fcvm.2023.1051862. eCollection 2023.

Abstract

OBJECTIVE

The goal of this study is to use superb microvascular imaging (SMI) to observe neovascularization in the carotid vessel wall to identify potential Takayasu's arteritis (TAK) inflammation markers.

METHODS

Bilateral carotid arteries from 96 patients with TAK were imaged by a Doppler ultrasound and SMI. The one-way analysis of variance (ANOVA) was used to document significant differences between the activity and inactivity stages of TAK and the factors closely related to its activity in the binary logistics regression equation. Clinical and laboratory data included age, gender, duration of disease, treatment history, NIH score, erythrocyte sedimentation rate (ESR), and high-sensitivity C-reactive protein. Imaging data included the arterial wall thickness, degree of lesion, SMI grade, and arterial aneurysm formation.

RESULTS

There were 45 patients in the active TAK stage and 51 in the inactive stage. The one-way ANOVA showed significant differences in SMI ( = 0.001) and ESR ( = 0.022) between the active and inactive groups. The binary logistics regression analysis showed that SMI was an independent risk factor for TAK activity (B = -1.505, S.E = 0.340, Wald = 19.528, OR = 0.222 95%, CI = 0.114-0.433,  < 0.01). Using SMI G1 or G2 as the cutoff values for the diagnosis of active TAK, the positive predictive value, sensitivity, and specificity were 60 and 86%, 84% and 56%, and 54% and 92%, respectively.

CONCLUSION

The SMI grade is a potential marker of disease activity in patients with TAK.

摘要

目的

本研究旨在运用超微血管成像(SMI)观察颈动脉血管壁的新生血管形成,以识别潜在的大动脉炎(TAK)炎症标志物。

方法

采用多普勒超声和SMI对96例TAK患者的双侧颈动脉进行成像。运用单因素方差分析(ANOVA)记录TAK活动期和非活动期之间的显著差异,以及二元逻辑回归方程中与其活动密切相关的因素。临床和实验室数据包括年龄、性别、病程、治疗史、美国国立卫生研究院(NIH)评分、红细胞沉降率(ESR)和高敏C反应蛋白。影像学数据包括动脉壁厚度、病变程度、SMI分级和动脉动脉瘤形成情况。

结果

TAK活动期患者45例,非活动期患者51例。单因素方差分析显示,活动组和非活动组在SMI(=0.001)和ESR(=0.022)方面存在显著差异。二元逻辑回归分析表明,SMI是TAK活动的独立危险因素(B=-1.505,标准误=0.340,Wald=19.528,OR=0.222,95%置信区间=0.114-0.433,<0.01)。以SMI G1或G2作为诊断活动期TAK的临界值,其阳性预测值、敏感性和特异性分别为60%和86%、84%和56%、54%和92%。

结论

SMI分级是TAK患者疾病活动的潜在标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e087/10025289/db51be4f18ff/fcvm-10-1051862-g001.jpg

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