摘要
目的应用超声造影探讨不同疾病状态下颈动脉粥样斑块内新生血管表现特点,评价超声造影对颈动脉斑块活动性评估的有效性。方法选取2015年7月~2016年6月113例颈动脉粥样斑块≥10x2mm的住院病人,分为糖尿病组(diabetic mellitus,DM组)25例、高脂血症组(hyperlipidemia,HL)29例、高血压组(hypertension,HBP组)34例及慢性肾功能衰竭组(chronic renal failure,CRF组)25例,比较各组间颈动脉粥样斑块超声声像图特征、斑块内新生血管增强程度,分析糖尿病、高脂血症、高血压、慢性肾功能衰竭患者颈动脉斑块内新生血管增强表现的差异性。结果 DM组(58.6%)和HL组(56.0%)颈动脉斑块超声造影视觉评分3级的比例明显高于HBP组(5.8%)和CRF组(16%)(P<0.05),DM组和HL组中多数斑块表现为由管壁向斑块内部的不同程度点状或短线状增强,基底部较内部密集,同时伴有管腔内向斑块的增强,且以周边及远心端增强更为显著。HBP组颈动脉粥样斑块超声造影视觉评分2级的比例(58.8%)明显高于DM组(31%)、HL组(12%)和CRF组(8%)(P<0.05),HBP组中多数斑块表现为管壁向斑块内部的不同程度点状增强,CRF组多数斑块内部出现强回声无明显增强(P<0.05),不同疾病状态下超声造影增强程度分布不同。结论超声造影可显示斑块内新生血管,DM组和HL组新生血管化程度高于HBP组和CRF组,HBP组血管新生化高于CRF组,颈动脉斑块超声造影评价不同疾病状态下颈动脉斑块新生血管化的不同表现,可作为临床评估斑块活动状态的一种有效方法。
Objective To explore the charateristics of neovascularization of carotid atherosclerosis plaque between different disease states by using contrastenhanced ultrasound （CEUS） and evaluate the activity of carotid plaques. Methods Hospitalized patients with carotid atheromatous plaque ≥10x2mm in July 2015 to June 2016 were inclueded and were divided into diabetic mellitus group （DM）, hyperlipidemia group（HL）, hypertension group（HBP） and chronic renal failure group （CRF）. Ultrasonographic characteristics and neovascularization between these groups were analyzed. Results In the contrastenhanced intensity visual grading, scores of plaque were more than 3 grade in DM （586%） and HL（560%） group, and higer than that of HBP group （58%） and CRF group （16%） （P〈0.05）. Most plaques of DM and HL group expressed dot or short linear increase from the wall to varying degrees, and denser in the base than inside. At the same time, it accompanied with more significant telecentric enhancement. Scores of HBP group （588%） were more than 2 grade, and higher than that in DM group （31%）, HL group （12%） and CRF group （8%） （P〈0.05）. Most plaques of HBP group expressed dot increase from the wall to varying degrees and that of CRF group expressed no increase with strong echo. Conclusion Contrastenhanced ultrasonography can display the new blood vessels inside plaque. The new biochemical blood vessels degree of DM and HL group are higher than that of HBP and CRF group, and that of HBP group is higher than CRF group. Contrastenhanced ultrasound is an effective method in the assesement of the state of carotid plaques activtity, and it can be used as a clinical evaluation of neovascularization under different disease states.
出处
《西部医学》
2018年第1期128-132,共5页
Medical Journal of West China
关键词
超声造影
颈动脉斑块
糖尿病
高脂血症
高血压
慢性肾功能衰竭
Contrast-enhanced ultrasound
Carotid atheromatous plaque
Diabetes mellitus, Hyperlipidemia
Hypertension, Chronic renal failure
作者简介
通讯作者：马晓娟，女，E—mail：xiaoiuanma@126．com
