Evaluation of changes of intra-wall neovascularization of the affected carotid artery thickening in TA patients before and after treatment based on SMI
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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.
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