CEUS定量评估大动脉粥样硬化性脑卒中患者易损斑块及其与循环血白细胞的相关性

目的 分析急性缺血性脑卒中患者颈动脉斑块CEUS定量参数与循环血白细胞的相关性。方法 收集经头颅CT或MR证实的首发急性大动脉粥样硬化性脑卒中患者62例（LAAS组），选取同期住院且年龄、性别匹配，无心脑血管事件发生史的动脉硬化患者54例为对照组。比较2组循环血白细胞指标与颈动脉斑块CEUS定量参数的相关性，建立多元线性回归模型，分析CEUS定量参数的影响因素。结果 LAAS组总白细胞计数、中性粒细胞计数、中性粒细胞/淋巴细胞比均高于对照组，而淋巴细胞计数低于对照组（P均< 0.05）。LAAS组颈动脉斑块CEUS参数时间-强度曲线（TIC）峰值强度（TIC-P）、强度均值（TIC-M）、伽马拟合曲线（FC）峰值（FC-P）、锐度（FC-S）和曲线下面积（FC-AUC）均大于对照组（P均< 0.05）；且中性粒细胞计数和中性粒细胞/淋巴细胞比值与FC-AUC值相关（r=0.298、0.739，P <均0.05）。总白细胞计数是TIC-P独立影响因素，中性粒细胞/淋巴细胞比是FC-AUC独立影响因素（P均< 0.05）。结论 颈动脉斑块CEUS定量参数与循环血白细胞存在相关性。循环血白细胞计数增高或中性粒细胞/淋巴细胞比值增大可致斑块易损性增加。

CEUS in quantitative evaluation of vulnerable plaques in patients with large artery atherosclerosis stroke: Correlation with leukocytes

Objective To observe the correlation between CEUS quantitative parameters of carotid plaques and leukocytes in patients with acute ischemic stroke. Methods Sixty-two patients with large artery atherosclerosis stroke (LAAS group) confirmed by CT or MRI were enrolled, while 54 patients in the same period of hospitalization, age and gender-matched, no history of cardiovascular events with atherosclerosis were taken as control group. The correlation between CEUS quantitative parameters of carotid plaques and leukocytes in two groups were compared. Multiple linear regression model was built and the risk factors of CEUS quantitative parameters were analyzed. Results The total leukocytes count, neutrophils count and neutrophil/lymphocyte ratio in LAAS group were higher, while the lymphocytes count was lower than those in control group (all P < 0.05). CEUS parameters, including time-intensity curve (TIC) peak (TIC-P), mean (TIC-M), fitting curve (FC) peak (FC-P), sharpness (FC-S) and area under the curve (FC-AUC) of carotid plaques were higher than those in control group (all P < 0.05), while neutrophils count and neutrophil/lymphocyte ratio were positively correlated with FC-AUC (r=0.298 and 0.739, respectively; all P < 0.05). Total leukocytes count was independent risk factor of TIC-P, and neutrophil/lymphocyte ratio was independent risk factor of FC-AUC (all P < 0.05). Conclusion CEUS quantitative parameters of carotid plaques related to leukocytes count. Increased leukocytes or neutrophil/lymphocyte ratio might rise vulnerability of plaques.