Echo-lucency of computerized ultrasound images of carotid atherosclerotic plaques are associated with increased levels of triglyceride-rich lipoproteins as well as increased plaque lipid content.
Echo-lucency of computerized ultrasound images of carotid atherosclerotic plaques are associated with increased levels of triglyceride-rich lipoproteins as well as increased plaque lipid content.
复制标题
颈动脉粥样硬化斑块的计算机超声图像的回声透明度与富含甘油三酯的脂蛋白水平的增加以及斑块脂质含量的增加有关。
作者：
M. Grønholdt;B. Nordestgaard;B. Wiebe;J. Wilhjelm;Henrik Sillesen
背景
计算机超声B型图像上颈动脉粥样硬化斑块的回声透明与CT扫描评估的脑梗死的高发病率相关。我们检验了以下假设：空腹和餐后状态下富含甘油三酯的脂蛋白可预测颈动脉斑块回声，回声可预测斑块脂质含量高。
方法和结果
该研究包括137名有神经系统症状和相关颈动脉狭窄≥ 50%的患者。颈动脉斑块的高分辨率B型超声图像经计算机处理，以产生回声（灰度级）的措施。在标准化脂肪餐之前和之后每小时测量脂蛋白，持续4小时。58例患者的亚组接受了动脉内膜切除术。在线性回归分析中，（低灰度级）与空腹和餐后血浆甘油三酯水平升高有关（P=.0002和P=.002），IDL胆固醇（P= 0.0009和P= 0.006），VLDL/乳糜微粒残余胆固醇（P= 0.0003和P= 0.0004）和甘油三酯（P= 0.0003和P= 0.003），脂肪餐后0至4小时血浆甘油三酯曲线下面积（P= 0.001）和体重指数（P= 0.0001）。在ANCOVA中，体重指数、空腹IDL胆固醇和空腹血浆甘油三酯是回声透亮的独立预测因子。回声透亮度与相对斑块脂质含量增加相关（P= 0.02）。
结论
血浆中富含磷脂酰肌醇的脂蛋白水平的升高预示颈动脉斑块的回声透亮，这与斑块脂质含量的增加有关。由于CT扫描显示回声透亮与脑梗死的高发病率相关，富含磷脂的脂蛋白可预测斑块类型特别容易破裂。
BACKGROUND
Echo-lucency of carotid atherosclerotic plaques on computerized ultrasound B-mode images has been associated with a high incidence of brain infarcts as evaluated on CT scans. We tested the hypotheses that triglyceride-rich lipoproteins in the fasting and postprandial state predict carotid plaque echo-lucency and that echo-lucency predicts a high plaque lipid content.
METHODS AND RESULTS
The study included 137 patients with neurological symptoms and > or = 50% stenosis of the relevant carotid artery. High-resolution B-mode ultrasound images of carotid plaques were computer processed to yield a measure of echogenicity (gray-scale level). Lipoproteins were measured before and hourly for 4 hours after a standardized fatty meal. A subgroup of 58 patients underwent endarterectomy. On linear regression analysis, echo-lucency (low gray-scale level) was associated with elevated levels of fasting and postprandial plasma triglycerides (P=.0002 and P=.002), IDL cholesterol (P=.0009 and P=.006), and VLDL/chylomicron remnant cholesterol (P=.0003 and P=.0004) and triglycerides (P=.0003 and P=.003), the area under the plasma triglyceride curve 0 to 4 hours after a fatty meal (P=.001), and body mass index (P=.0001). On ANCOVA, body mass index, fasting IDL cholesterol, and fasting plasma triglycerides were independent predictors of echo-lucency. Echo-lucency was associated with increased relative plaque lipid content (P=.02).
CONCLUSIONS
Increased plasma levels of triglyceride-rich lipoproteins predict echo-lucency of carotid plaques, which is associated with increased plaque lipid content. Because echo-lucency has been associated with a high incidence of brain infarcts on CT scans, triglyceride-rich lipoproteins may predict a plaque type particularly vulnerable to rupture.
富含甘油三酯的脂蛋白和动脉粥样硬化：病理生理学考虑。
DOI：
--
发表时间：
1994
期刊：
Journal of internal medicine. Supplement
影响因子：
--
作者：
Bradley,WA;Gianturco,SH
通讯作者：
Gianturco,SH
餐后脂血症：流行病学现场研究的可靠性。
影响因子：
5
作者：
Brown,SA;Chambless,LE;Sharrett,AR;GottoJr,AM;Patsch,W
通讯作者：
Patsch,W