Application analysis of carotid ultrasound combined with detections of vascular endothelial growth factor, matrix metalloproteinase-9 and hypersensitive C-reactive protein in the stability of atherosclerotic plaque
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摘要:目的 探讨颈动脉超声联合血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)、超敏C反应蛋白(hs-CRP)检测在动脉粥样硬化斑块稳定性中的应用效果。方法 选取98例动脉粥样硬化患者, 均行颈动脉超声联合VEGF、MMP-9、hs-CRP检测，并以随访及磁共振检查为对照，比较颈动脉超声与颈动脉超声联合VEGF、MMP-9、hs-CRP检测结果，以及不同斑块类型患者血清VEGF、MMP-9、hs-CRP水平。结果 经随访及组织病理学发现, 98例动脉粥样硬化患者中，无斑块33例，稳定性斑块32例，易损性斑块33例。颈动脉超声联合VEGF、MMP-9、hs-CRP检测无斑块、稳定性斑块及易损性斑块的准确性均显著高于颈动脉超声检测(P < 0.05); 稳定性斑块患者血清VEGF、MMP-9及hs-CRP水平均显著高于无斑块患者，显著低于易损性斑块患者(P < 0.05)。结论 颈动脉超声联合VEGF、MMP-9、hs-CRP检测可准确明确动脉粥样硬化斑块性质，反映斑块稳定性及病变程度。Abstract:Objective To investigate the effect of carotid ultrasound combined with detections of vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9) and hypersensitive C-reactive protein (hs-CRP) in the stability of atherosclerotic plaque.Methods Totally 98 patients with atherosclerosis were conducted with carotid ultrasound and detections of VEGF, MMP-9 and hs-CRP. Taking the results of follow-up and magnetic resonance imaging as controls, the results of carotid ultrasound and carotid ultrasound combined with VEGF, MMP-9, hs-CRP were compared, and the serum levels of VEGF, MMP-9 and hs-CRP in patients with different plaque types were compared as well.Results Follow-up and histopathological findings showed that among 98 patients with atherosclerosis, 33 cases had no plaque, 32 cases had stable plaque and 33 cases had vulnerable plaque. The accuracy of carotid ultrasound combined with VEGF, MMP-9 and hs-CRP in detecting non-plaque, stable plaque and vulnerable plaque was significantly higher than that of carotid ultrasound (P < 0.05). The serum levels of VEGF, MMP-9 and hs-CRP in patients with stable plaque were significantly higher than those without plaque, and was significantly lower than those with vulnerable plaque (P < 0.05).Conclusion Carotid ultrasound combined with detection of VEGF, MMP-9 and hs-CRP can accurately determine the nature of atherosclerotic plaque and reflect the stability and degree of atherosclerotic plaque.
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表 1 2种检查方法检测动脉粥样硬化斑块结果比较[n(%)]
检查方法 无斑块(n=33) 稳定性斑块(n=32) 易损性斑块(n=33) 颈动脉超声 27(81.82) 26(81.25) 27(87.88) 颈动脉超声联合血清VEGF、MMP-9、hs-CRP 33(100.00)* 32(100.00)* 33(100.00)* 与颈动脉超声比较, *P < 0.05。 
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表 2 不同斑块类型患者血清VEGF、MMP-9、hs-CRP水平对比(x±s)
斑块类型 VEGF/(pg/mL) MMP-9/(mg/L) hs-CRP/(μg/L) 无斑块(n=33) 0.39±0.01 993.86±94.92 5.02±1.21 稳定性斑块(n=32) 0.45±0.01* 1043.27±89.73* 10.82±1.31* 易损性斑块(n=33) 0.79±0.02*# 1228.56±87.32*# 13.87±2.75*# VEGF: 血管内皮生长因子; MMP-9: 基质金属蛋白酶-9; hs-CRP: 超敏C反应蛋白。 与无斑块比较, *P < 0.05; 与稳定性斑块比较, #P < 0.05。
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[1] 郭妍, 于冬, 赵志刚. 多普勒能量图判断颈动脉粥样硬化斑块形成前后管腔内血流状态变化的价值[J]. 临床和实验医学杂志, 2018, 17(6): 593-595. doi: 10.3969/j.issn.1671-4695.2018.06.010 [2] 周成礼, 房袁媛. 动态动脉硬化指数和颈动脉超声相关参数与冠状动脉粥样硬化性心脏病的关系[J]. 临床超声医学杂志, 2017, 19(7): 444-448. doi: 10.3969/j.issn.1008-6978.2017.07.005 [3] 黄俊英, 黄品同, 张莹. 超声检查与CT血管成像检查评价颈动脉狭窄的对比研究[J]. 浙江医学, 2017, 39(5): 336-339, 344. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJYE201705005.htm [4] 何宏涛, 杨秀平, 张志敏. MMP-9、TIMP-1和VEGF与颈动脉粥样硬化斑块稳定性的关系研究[J]. 河北医药, 2016, 38(4): 555-557. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYZ201604025.htm [5] 吴婉玉, 廖峻, 黄劼, 等. 急性前循环脑梗死患者血压变异性与颈动脉粥样硬化斑块的相关性[J]. 西部医学, 2017, 29(6): 795-798. doi: 10.3969/j.issn.1672-3511.2017.06.012 [6] 李伟霞, 周宇. 超声检查颈动脉粥样硬化斑块与冠心病诊断的初步研究[J]. 贵州医药, 2012, 36(9): 841-842. doi: 10.3969/j.ISSN.1000-744X.2012.09.034 [7] 刘强, 宇辉. 颈动脉粥样硬化斑块及血清炎症因子与老年脑梗死发病的相关性分析[J]. 山东医药, 2017, 57(45): 98-100. doi: 10.3969/j.issn.1002-266X.2017.45.033 [8] 郭恩会, 路青山, 杨霄鹏, 等. 阿托伐他汀对大鼠颈动脉粥样硬化易损斑块及hs-CRP和MMP-9表达的影响[J]. 中风与神经疾病杂志, 2016, 33(4): 307-310. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFSJ201604006.htm [9] 吴启兵, 舒红, 罗善和, 等. 颈动脉超声评估颈动脉粥样硬化斑块易损性的临床价值[J]. 岭南心血管病杂志, 2017, 23(4): 432-434. doi: 10.3969/j.issn.1007-9688.2017.04.18 [10] 宋颖, 李晓燕. 冠状动脉粥样硬化斑块稳定性与血清基质金属蛋白酶-9及超敏C反应蛋白浓度的关系[J]. 岭南心血管病杂志, 2017, 23(5): 610-613. doi: 10.3969/j.issn.1007-9688.2017.05.28 [11] 解冰川, 韩瑞, 仇福成, 等. 基质金属蛋白酶-9及超敏C反应蛋白与颈动脉斑块稳定性关系的研究[J]. 中国医师杂志, 2015, 17(4): 592-594. doi: 10.3760/cma.j.issn.1008-1372.2015.04.038 [12] 景江新, 宋鹏远, 陈胜国, 等. 颈动脉超声造影检查对颈动脉粥样硬化的评估作用[J]. 中国循证心血管医学杂志, 2016, 8(9): 1122-1122. doi: 10.3969/j.issn.1674-4055.2016.09.32 [13] 于治华, 王君, 樊建华, 等. 急性脑梗死患者外周血清巨噬细胞移动抑制因子、基质金属蛋白酶-9和超敏C-反应蛋白水平与病情严重程度的关系[J]. 中国康复理论与实践, 2015, 21(11): 1256-1259. doi: 10.3969/j.issn.1006-9771.2015.11.004 [14] 孙雁, 周爱云, 廖涛, 等. 超声诊断颈动脉粥样硬化斑块及其形成危险因素分析[J]. 临床超声医学杂志, 2016, 18(9): 624-626. https://www.cnki.com.cn/Article/CJFDTOTAL-LCCY201609018.htm [15] 张东凤, 吕树铮, 宋现涛. 炎性因子与轻中度冠状动脉狭窄患者斑块形态学特征的相关性研究[J]. 中国介入心脏病学杂志, 2016, 24(10): 569-574. doi: 10.3969/j.issn.1004-8812.2016.10.006
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