Evaluation of changes of intra-wall neovascularization of the affected carotid artery thickening in TA patients before and after treatment based on SMI
-
摘要: 目的:探讨超微细血管成像技术(SMI)评估多发性大动脉炎(TA)患者受累颈动脉增厚管壁内新生血管治疗前后的变化。方法:前瞻性选取2018年1月—2020年1月我院收治的45例TA患者,根据病情分为临床活动期组(28例)和非活动期组(17例)。比较两组红细胞沉降率(ESR)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、受累颈动脉管壁厚度、SMI分级评分等。结果:受累颈动脉管壁厚度+SMI分级+ESR+CRP+IL-6评估TA疾病活动性的AUC最高,为0.926(P＜0.05);临床活动期组患者治疗后ESR、CRP、IL-6、受累颈动脉管壁厚度、SMI分级评分低于治疗前(P＜0.05);受累颈动脉管壁厚度、SMI分级评分差值与美国国立卫生研究院大动脉炎评分(NIH)差值呈正相关(P＜0.05)。结论:SMI技术可观察TA患者受累颈动脉增厚管壁内新生血管情况,有望成为TA病情活动状态、临床决策、治疗、随访的一种有效、无创、简便辅助性评估策略。Abstract: Objective: To investigate the changes of superb micro-vascular imaging(SMI) before and after treatment of neovascularization in the thickened carotid artery wall of patients with takayasu arteritis(TA).Methods: Prospectively selected 45 TA patients admitted to our hospital from January 2018 to January 2020, and divided them into clinical active group(n=28) and inactive group(n=17) according to their condition. The erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), interleukin-6(IL-6), thickness of the affected carotid artery wall and SMI grade score were compared.Results: The AUC of TA disease activity assessed by the thickness of the affected carotid artery wall + SMI grade + ESR + CRP + IL-6 was 0.926(P＜0.05); the ESR, CRP, IL-6, thickness of the affected carotid artery wall and SMI grade score of patients in the clinical active group after treatment were lower than those before treatment(P＜0.05); the thickness of the affected carotid artery wall and the difference in SMI grade score were positively correlated with the difference in National Institutes of Health's Arteritis Score(NIH)(P＜0.05).Conclusion: SMI technology can observe the neovascularization in the thickened carotid artery wall of TA patients. It is expected to be an effective, non-invasive and simple auxiliary evaluation strategy for TA disease activity, clinical decision-making, treatment and follow-up.
-
-
[1] Keser G,Aksu K,Direskeneli H.Takayasu arteritis:an update[J].Turk J Med Sci,2018,48(4):681-697.
[2] 文莉莉,尉志红,刘瑞红,等.血管超声造影在基层医院多发性大动脉炎诊疗中的应用价值[J].中国药物与临床,2019,19(16):2758-2760.
[3] Jain A,Kumar D,Guleria A,et al.NMR-based serum metabolomics of patients with takayasu arteritis:relationship with disease activity[J].J Proteome Res,2018,17(9):3317-3324.
[4] Barra L,Kanji T,Malette J,et al.Imaging modalities for the diagnosis and disease activity assessment of Takayasu's arteritis:A systematic review and meta-analysis[J].Autoimmun Rev,2018,17(2):175-187.
[5] Lottspeich C,Dechant C,Kohler A,et al.Assessment of disease activity in takayasu arteritis:potential role of contrast-enhanced ultrasound[J].Ultraschall Med,2019,40(5):638-645.
[6] Huang Y,Ma X,Li M,et al.Carotid contrast-enhanced ultrasonographic assessment of disease activity in Takayasu arteritis[J].Eur Heart J Cardiovasc Imaging,2019,20(7):789-795.
[7] 张开元,杨兵社,左秀娟,等.超微血管成像技术检测颈动脉斑块新生血管的临床价值[J].中华实用诊断与治疗杂志,2019,33(10):1015-1017.
[8] 王欣,喻晓娜,杨宝莹,等.应用超微血流成像技术评价大动脉炎颈动脉新生血管[J].中国医师进修杂志,2020,43(4):339-342.
[9] Arend WP,Michel BA,Bloch DA,et al.The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis[J].Arthritis Rheum,1990,33(8):1129-1134.
[10] 侯颖,王佳,苏小佩,等.超声造影对多发性大动脉炎活动性的评价[C].中国超声医学工程学会第十四届全国颅脑及颈部血管超声学术大会.2018.
[11] 廖华,潘丽丽,杜娟,等.大动脉炎患者血清25羟维生素D水平及与白细胞介素-6水平的相关性[J].中华医学杂志,2018,98(43):3509-3512.
[12] Hellmich B,Agueda A,Monti S,et al.2018 Update of the EULAR recommendations for the management of large vessel vasculitis[J].Ann Rheum Dis,2020,79(1):19-30.
[13] Goel R,Danda D,Joseph G,et al.Long-term outcome of 251 patients with Takayasu arteritis on combination immunosuppressant therapy:Single centre experience from a large tertiary care teaching hospital in Southern India[J].Semin Arthritis Rheum,2018,47(5):718-726.
[14] Sun Y,Ma L,Chen H,et al.Analysis of predictive factors for treatment resistance and disease relapse in Takayasu's arteritis[J].Clin Rheumatol,2018,37(10):2789-2795.
[15] Wang Z,Dang A,Lv N.Brachial-Ankle Pulse Wave Velocity is Increased and Associated with Disease Activity in Patients with Takayasu Arteritis[J].J Atheroscler Thromb,2020,27(2):172-182.
[16] 魏冬梅.正电子发射计算机断层显像/计算机断层扫描在活动性大动脉炎诊断中的应用[D].2018:5-19.
[17] 李治琴,郑朝晖,杜望磊,等.血小板/淋巴细胞比值和粒细胞/淋巴细胞比值与大动脉炎疾病活动性的关系[J].中华心血管病杂志,2018,46(9):713-718.
[18] Sun Y,Ma L,Ma L,et al.Cyclophosphamide could be a better choice than methotrexate as induction treatment for patients with more severe Takayasu's arteritis[J].Rheumatol Int,2017,37(12):2019-2026.
[19] Cui X,Dai X,Ma L,et al.Efficacy and safety of leflunomide treatment in Takayasu arteritis:Case series from the East China cohort[J].Semin Arthritis Rheum,2020,50(1):59-65.
[20] Gomez L,Chaumet-Riffaud P,Noel N,et al.Effect of CRP value on 18F-FDG PET vascular positivity in Takayasu arteritis:a systematic review and per-patient based meta-analysis[J].Eur J Nucl Med Mol Imaging,2018,45(4):575-581.
[21] Keser G,Aksu K,Direskeneli H.Discrepancies between vascular and systemic inflammation in large vessel vasculitis:an important problem revisited[J].Rheumatology(Oxford),2018,57(5):784-790.
[22] Cheng F,Shao Z,Lu QS,et al.Aneurysms in Takayasu's arteritis:a retrospective study of Chinese patients[J].Clin Exp Rheumatol,2020,38 Suppl 124(2):42-47.
[23] 谢霞,白志勇,刘悦,等.超微血流成像技术在颈动脉易损斑块诊断中的应用价值[J].中国医学科学院学报,2018,40(4):444-449.
[24] 王立娟,张蕾,包晶晶,等.微细血管成像技术对多发性大动脉炎分期诊断的价值[J].中国超声医学杂志,2017,33(11):1034-1036.
[25] Hu Y,Zhang Q,Li C.Computer-assisted quantitative analysis of contrast-enhanced ultrasonography in Takayasu arteritis carotid artery lesions[J].Sheng Wu Yi Xue Gong Cheng Xue Za Zhi,2017,34(5):790-796.
[26] 蒋鑫萍,刘金香,王军,等.多发性大动脉炎合并下肢静脉受累超声诊断与临床治疗1例[J].中华超声影像学杂志,2018,27(4):357-359.
[27] 刘新正,李晓龙.血栓弹力图监测抗血小板药物抑制率在老年急性冠脉综合征患者临床治疗中的价值[J].临床血液学杂志,2020,33(6):425-427.
[28] 杨帅,史河水,韩萍,等.基于MSCTA的主动脉壁内血肿预后危险因素的Logistic回归分析[J].临床心血管病杂志,2017,33(12):1156-1161.
-
计量
- 文章访问数: 421
- PDF下载数: 75
- 施引文献: 0
下载: