应用光学相干断层成像对老年与中青年颈动脉粥样硬化性斑块特征的分析

目的 应用光学相干断层成像(OCT)评价老年与中青年患者颈动脉粥样硬化性斑块特征的区别.方法 回顾性连续纳入2017年6月至2021年2月在东部战区总医院神经内科完成颈动脉OCT检查的颈动脉粥样硬化性狭窄患者86例,分别将年龄<60岁、年龄≥60岁患者分为中青年组(17例,占19.8％)和老年组(69例,占80.2％)...

Application of optical coherence tomography to evaluate the difference in the characteristics of carotid atherosclerotic plaque between elderly patients and young or middle-aged patients

Objective To evaluate and analyze the difference of the characteristics of carotid atherosclerotic plaque between in elderly patients and young or middle-aged patients using optical coherence tomography(OCT).Methods A retrospective analysis was used to continuously enroll 86 patients with carotid atherosclerotic stenosis who completed the carotid artery OCT examination in the Department of Neurology,General Hospital of Eastern Theater Command,from June 2017 to February 2021.The patients were divided into the young or middle-aged group(<60 years old,17 cases[19.8%])and the elderly group(≥60 years old,69 cases[80.2%]).The patient′s age,sex,ipsilateral symptomatic carotid plaque,underlying diseases(hypertension,diabetes,hyperlipidemia,stroke,coronary heart disease),smoking history,drug use history(statins,Aspirin,clopidogrel,anticoagulant drugs),baseline laboratory indicators(fasting blood glucose,triacylglycerol,total cholesterol,high-density lipoprotein,low-density lipoprotein),carotid plaque characteristics(plaque rupture,lipid-rich plaque,American Heart Association[AHA]typeⅥplaque,minimum lumen area,fibrous cap thickness,thrombus ratio,fibrous plaque,atherosclerotic plaque with thin fibrous cap,macrophage infiltration,calcified plaques,new vasa vasorum,etc.)were collected and recorded between groups.Results(1)The age of the elderly group was higher than that of the young or middle-aged group,and the difference between the groups was statistically significant(68[64,71]years old vs.53[50,57]years old,Z=6.369,P<0.01).There were no statistically significant differences between two groups in sex,ipsilateral symptomatic carotid plaque,hypertension,diabetes,hyperlipidemia,coronary heart disease,stroke,smoking history,drug use history,triacylglycerol,total cholesterol,high-density lipoprotein,low-density lipoprotein,fasting blood sugar(all P>0.05).(2)The proportions of plaque rupture,lipid-rich plaque,and AHAⅥtype plaque in the elderly group were higher than those in the young or middle-aged group,and the differences were statistically significant(41/69 vs.5/17,χ²=4.937;52/69 vs.8/17,χ²=5.180;37/69 vs.4/17;all P<0.05).There were no statistically significant differences between two groups in the minimum lumen area,fiber cap thickness,thrombus proportion,fibrous plaque proportion,the proportion of atherosclerotic plaque with thin fibrous cap,the proportion of macrophage infiltration,calcified plaque proportion,and new vasa vasorum proportion(all P>0.05).Conclusions Compared with young or middle-aged patients,carotid atherosclerotic plaques in elderly patients are more prone to lipid-rich plaques,AHAⅥtype plaque and plaque rupture.However,carotid atherosclerotic plaque in young or middle-aged patients can be accompanied by thrombosis and new vasa vasorum.Attention should be paid to the management of carotid atherosclerotic plaque in young or middle-aged patients.The conclusions of this study need to be further verified.