上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (12): 1640-.doi: 10.3969/j.issn.1674-8115.2017.12.010?

• 论著（临床研究） • 上一篇    下一篇

急性大动脉粥样硬化性脑卒中患者颈动脉斑块超声造影定量 指标与循环血白细胞的关系

李朝军 1，李万斌 1，白云 1，杨青 1，杜联芳 1，罗向红 2   

  1. 上海交通大学附属第一人民医院  1. 超声影像科，2. 心超室，上海  200080
  • 出版日期:2017-12-28 发布日期:2018-01-10
  • 作者简介:李朝军（1975—），男，副主任医师，硕士；电子信箱：lzj_1975@sina.com
  • 基金资助:
    上海市科学技术委员会医学引导类科技项目（15411969100，16411969300）；上海市卫生和计划生育委员会基金(201440290，201640043）；促进市 级医院临床技能与临床创新能力三年行动计划（16CR3105B）；上海交通大学医工交叉研究基金（YG2015MS28）；上海交通大学医学院科技处技术转移推广项 目（ZT201710, ZT201711）

Relationship between quantitative indices of carotid plaque from contrast-enhanced ultrasound and leukocytes in patients with acute large artery atherosclerotic stroke#br#

LI Zhao-jun1, LI Wan-bin1, BAI Yun1, YANG Qing1, DU Lian-fang1, LUO Xiang-hong2   

  1. 1.Department of Ultrasound, 2. Department of Echocardiography, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
  • Online:2017-12-28 Published:2018-01-10
  • Supported by:
    Shanghai Science and Technology Committee Fund, 15411969100, 16411969300; Shanghai Health and Family Planning Commission Fund, 201440290, 201640043; Three-year Plan for Clinical Skills and Innovation in Municipal Hospitals, 16CR3105B; Interdisciplinary Program of Shanghai Jiao Tong University, YG2015MS28; Technology Transfer Project of Science & Technology Dept., Shanghai Jiao Tong University School of Medicine, ZT201710, ZT201711

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摘要： 目的 · 探讨急性大动脉粥样硬化性脑卒中（LAAS）患者颈动脉斑块超声造影定量指标与循环血白细胞的相关性及其价值。方 法 · 选择 2016 年 6 月—2017 年 6 月于上海交通大学附属第一人民医院收治的 LAAS 患者 62 例（脑卒中组），选取同期对照组受试者 48 例。颈动脉优势斑块行超声造影，获取斑块时间 - 强度曲线（TIC）定量参数，即峰值强度（PTIC）和强度均值（MTIC）；斑块时间 强度拟合曲线（FC）定量参数，即峰值（PFC）、锐度（SFC）和曲线下面积（AUCFC）。斑块定量参数的组间比较用两样本t 检验，与 循环血白细胞计数的相关性采用 Pearson 相关分析。结果 · ①脑卒中组患者总白细胞、中性粒细胞计数高于对照组，而淋巴细胞计数低 于对照组（均P<0.05）。②脑卒中组患者斑块超声造影定量参数PTIC、MTIC、PFC、SFC 和 AUCFC 值均大于对照组（均P<0.05）。③ PTIC、 MTIC 和 PFC 与淋巴细胞数呈负相关（r 分别为 -0.291、-0.263 和 -0.270，均 P<0.05）； SFC 和 AUCFC 与中性粒细胞数呈正相关（r 分别为 0.261 和 0.298，均 P<0.05）。 结论 · 颈动脉斑块的定量超声造影定量指标与循环血白细胞相关，其关联性有助于判断斑块的易损性。

关键词: 超声造影成像技术, 动脉粥样硬化, 脑卒中, 斑块, 白细胞

Abstract:

Objective · To investigate the relationship between quantitative indices of carotid plaques from contrast-enhanced ultrasound and leukocytes, and explore the value in the patients with acute large artery atherosclerotic stroke (LAAS).  Methods · A total of 62 patients with LAAS and 48 matched control subjects hospitalized in Shanghai General Hospital, Shanghai Jiao Tong University from June 2016 to June 2017 were enrolled. Obvious carotid plaques were examined by contrast-enhanced ultrasound. The parameters of time-intensity curve i.e. peak (PTIC) and mean (MTIC), and the parameters of fitting curve i.e. peak (PFC), sharpness (SFC), and under the curve area (AUCFC) were obtained. These parameters were compared between the groups using two samples t tests. The correlations between the parameters and leukocyte counts were analyzed by Pearson correlation analysis.  Results · ① In LAAS group, the total leukocyte and neutrophil counts were higher than those of the control group, while the lymphocyte count was lower than that of the control group (P<0.05). ② The PTIC, MTIC, PFC, SFC and AUCFC were significantly larger in LAAS group than those in the control group, respectively (P<0.05). ③ PTIC, MTIC and PFC were negatively correlated with lymphocytes, respectively (r=-0.291, -0.263 and -0.270, P<0.05). SFC and AUCFC were positively correlated with neutrophils, respectively (r=0.261 and 0.298, P<0.05).  Conclusion · Quantitative indices of carotid plaques from contrast-enhanced ultrasound are associated with circulating leukocytes, and the association helps assess the vulnerability of the plaques.

Key words: contrast-enhanced ultrasound, atherosclerosis, stroke, plaque, leukocyte