摘要
目的颈动脉斑块内出血（IPH）是导致缺血性卒中的重要病因之一。本研究旨在尝试探索血清CD147水平对于颈动脉IPH诊断价值，寻求IPH的血清学标志物。方法纳入自2014年4至9月复旦大学附属华山医院血管外科收治的共68例颈动脉硬化狭窄患者的血清样本。使用3.0T MRI结合8通道颈动脉体表线圈扫描颈动脉，通过斑块成分分析系统进行图像后处理，定性定量斑块内的脂质、IPH、钙化成分以及纤维帽的完整性，结合血清CD147的检测结果，进行相关性及差异性分析。结果血清CD147在存在IPH组（5 510.1 ng/L）较不存在IPH组（4 648.0 ng/L）更高（P＝0.04）。血清CD147与颈动脉斑块内脂质、IPH、钙化的定量参数及纤维帽破裂均无显著相关性。使用他汀类药物较不使用时，血清CD147更低（4 914.0与5 926.7，P〈0.01）。血清总胆固醇与低密度脂蛋白与血清CD147呈正相关。在男性未使用他汀类药物干预下，血清CD147对颈动脉IPH有较好的诊断价值（AUC＝0.81，P＝0.04，95% CI 0.62～0.99）。结论血清CD147可能成为IPH的血清学标志物，对特定人群的颈动脉IPH存在诊断价值。
ObjectiveIntraplaque hemorrhage （IPH） is one of the most important causes of ischemic stroke. The purpose of this study was to explore the association between carotid IPH and CD147, which may be the serum marker related to IPH.MethodsSerum samples were collected from 68 patients with carotid artery stenosis from April to September 2004. 3.0T MRI with the 8 channel surface coil was used to scan carotid artery. Images was processed by MRI-PlaqueView. The integrity of lipid, IPH, calcified components and fibrous cap in the plaque was analysed qualitatively and quantitatively. The correlation and difference analysis among serum CD147 and plaque components were carried out.ResultsSerum CD147 level in IPH positive was higher than that in IPH negative, 5 510.1 vs 4 648.0 （P=0.04）. There was no significant correlation among serum CD147 and the quantitative parameters of lipid, IPH and calcification in carotid plaque and fibrous cap rupture. Serum CD147 in patients using statins was lower than that in patients not using statins, 4 914.0 vs 5 926.7 （P〈0.01）. Serum total cholesterol and LDL were positively correlated with serum CD147. In patients without statin, serum CD147 had a better diagnostic value for carotid IPH （AUC=0.81, P=0.04, 95% CI 0.62-0.99）.ConclusionSerum CD147 would probably be one biomarker of IPH and shows good diagnostic value of carotid IPH in the specific population.
作者
郭文城
崔梅
王寻
陶虹月
余波
Guo Wencheng , Cui Mei , Wang Xun, Tao Hongyue, Yu Bo.(Department of Vascular Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2018年第42期3437-3441,共5页
National Medical Journal of China
基金
上海市医学重点专科项目（ZK2015A16）
