超声联合血清S100B及神经胶质纤维酸性蛋白水平评估颈动脉易损斑块的临床价值

doi:10.11958/20253193

天津医药 ›› 2026, Vol. 54 ›› Issue (9): 928-933.doi: 10.11958/20253193

超声联合血清S100B及神经胶质纤维酸性蛋白水平评估颈动脉易损斑块的临床价值

王晶¹(), 马媛媛²^,^△(), 王智培¹, 赵文慧¹, 徐婷婷¹

¹ 沧州市人民医院超声科（邮编061000）
² 沧州市人民医院神经内一科（邮编061000）

收稿日期:2025-10-20 修回日期:2026-04-02 出版日期:2026-09-15 发布日期:2026-09-14
通讯作者: ^△E-mail：13582759560@163.com
作者简介:王晶（1990），女，主治医师，主要从事血管超声方面研究。E-mail：zhangzzdd0313@163.com
基金资助:
河北省医学科学研究课题(20251504)

Clinical value of ultrasound and serum S100B combined with glial fibrillary acidic protein in evaluating carotid vulnerable plaque

WANG Jing¹(), MA Yuanyuan²^,^△(), WANG Zhipei¹, ZHAO Wenhui¹, XU Tingting¹

¹ Department of Ultrasound, Cangzhou People's Hospital, Cangzhou 061000, China
² Department of Neurology I, Cangzhou People's Hospital, Cangzhou 061000, China

Received:2025-10-20 Revised:2026-04-02 Published:2026-09-15 Online:2026-09-14
Contact: ^△E-mail：13582759560@163.com

王晶, 马媛媛, 王智培, 赵文慧, 徐婷婷. 超声联合血清S100B及神经胶质纤维酸性蛋白水平评估颈动脉易损斑块的临床价值[J]. 天津医药, 2026, 54(9): 928-933.

WANG Jing, MA Yuanyuan, WANG Zhipei, ZHAO Wenhui, XU Tingting. Clinical value of ultrasound and serum S100B combined with glial fibrillary acidic protein in evaluating carotid vulnerable plaque[J]. Tianjin Medical Journal, 2026, 54(9): 928-933.

摘要/Abstract

摘要：

目的探讨超声联合血清S100钙结合蛋白B（S100B）及神经胶质纤维酸性蛋白（GFAP）水平评估颈动脉易损斑块的临床价值。方法选取100例颈动脉狭窄合并颈动脉斑块患者。根据患者CT血管造影（CTA）检查所见的斑块衰减密度、高分辨MRI特征和术后病理结果将患者分为易损斑块组（63例）和稳定斑块组（37例）。收集患者的一般资料、实验室指标、颈动脉超声检测结果。应用二元Logistic回归模型分析颈动脉斑块稳定性的影响因素；绘制受试者工作特征（ROC）曲线评估研究指标对患者颈动脉易损斑块的预测价值。结果易损斑块组患者的血清S100B、GFAP水平均高于稳定斑块组（P<0.05）；以CTA、高分辨MRI及术后病理的综合诊断结果为金标准，将患者分为易损斑块组（63例）和稳定斑块组（37例）。经颈动脉超声检测评估出易损斑块66例、稳定斑块34例，其中Ⅰ型30例、Ⅱ型36例、Ⅲ型12例、Ⅳ型9例、Ⅴ型13例。颈动脉超声检测结果与金标准比较，二者一致性Kappa值为0.760；Logistic回归分析显示，高水平的血清S100B（OR=50.286，95%CI：7.648~330.815）、GFAP（OR=1.165，95%CI：1.086~1.251）均为患者颈动脉易损斑块的危险因素（P<0.05）；ROC曲线结果显示，血清S100B、血清GFAP、超声及三者联合预测患者颈动脉易损斑块的曲线下面积（AUC）分别为0.820（95%CI：0.731~0.890）、0.855（95%CI：0.771~0.918）、0.874（95%CI：0.792~0.932）、0.918（95%CI：0.846~0.964），敏感度分别为76.19%、73.02%、93.65%、73.02%，特异度分别为83.78%、86.49%、81.08%、97.30%，预测效能均较高。结论通过超声联合血清S100B、GFAP水平有助于识别患者颈动脉易损斑块。

关键词: 颈动脉, 超声检查, 血管造影术, S100钙结合蛋白β亚基, 神经胶质原纤维酸性蛋白质, 易损斑块

Abstract:

Objective To explore the clinical value of ultrasound combine with serum S100 calcium binding protein B (S100B) combined and glial fibrillary acidic protein (GFAP) in evaluating carotid vulnerable plaque. Methods A total of 100 patients with carotid stenosis complicated with carotid plaque who received computed tomography angiography (CTA) in Cangzhou People’s Hospital were selected. All patients received carotid ultrasound examination. Patients were divided into the vulnerable plaque group (n=63) and the stable plaque group (n=37) according to CTA attenuation density, high-resolution MRI and postoperative pathological results. General information, laboratory indicators and carotid ultrasound results were collected. Binary Logistic regression model was used to analyze the influencing factors of carotid plaque stability. Receiver operating characteristic (ROC) curves were drawn to evaluate the predictive value of the study indicators on carotid vulnerable plaque in patients. Results The levels of serum S100B and GFAP were higher in the vulnerable plaque group than those in the stable plaque group (P<0.05). According to the gold standard of comprehensive diagnostic results of CTA, high-resolution MRI and postoperative pathology, 100 patients were divided into the vulnerable plaque group (n=63) and the stable plaque group (n=37). Carotid ultrasonography identified 66 cases of vulnerable plaques and 34 cases of stable plaques, including 30 cases of type Ⅰ, 36 cases of type Ⅱ, 12 cases of type Ⅲ, 9 cases of type Ⅳ and 13 cases of type Ⅴ. The Kappa value for the consistency between carotid ultrasound findings and the gold standard was 0.760. Logistic regression analysis showed that high levels of serum S100B (OR=50.286, 95%CI: 7.648-330.815) and GFAP (OR=1.165, 95%CI: 1.086-1.251) were risk factors for carotid plaque vulnerability (P<0.05). ROC curve results suggested that the AUCs of serum S100B, GFAP, ultrasound and the combination of the three in predicting carotid vulnerable plaque were 0.820 (95%CI: 0.731-0.890), 0.855 (95%CI: 0.771-0.918), 0.874 (95%CI: 0.792-0.932) and 0.918 (95%CI: 0.846-0.964), and the sensitivities were 76.19%, 73.02%, 93.65% and 73.02%, the specificities were 83.78%, 86.49%, 81.08% and 97.30% respectively, with high predictive efficiency. Conclusion Ultrasound combined with serum S100B and GFAP are helpful for the clinical diagnosis of vulnerable plaque in patients with carotid plaques.

Key words: carotid artery, ultrasonography, angiography, S100 calcium binding protein beta subunit, glial fibrillary acidic protein, vulnerable plaque

中图分类号:

R445.1

图/表 6

参考文献 22

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组别	n			性别（男/女）			年龄/岁		BMI/（kg/m²）
易损斑块组	63			41/22			63.97±4.02		23.94±2.57
稳定斑块组	37			27/10			63.06±4.68		23.61±2.36
χ²或t				0.667			1.028		0.639
组别		吸烟史			饮酒史			高血压史			糖尿病史
易损斑块组		32（50.8）			19（30.2）			26（41.3）			22（34.9）
稳定斑块组		16（43.2）			10（27.0）			12（32.4）			11（29.7）
χ²		0.532			0.111			0.773			0.284
组别			高血脂史			SBP/mmHg				DBP/mmHg
易损斑块组			37（58.7）			131.28±13.05				81.52±7.54
稳定斑块组			20（54.1）			127.39±12.28				79.64±9.15
χ²或t			0.208			1.470				1.111

组别	n			性别（男/女）			年龄/岁		BMI/（kg/m²）
易损斑块组	63			41/22			63.97±4.02		23.94±2.57
稳定斑块组	37			27/10			63.06±4.68		23.61±2.36
χ²或t				0.667			1.028		0.639
组别		吸烟史			饮酒史			高血压史			糖尿病史
易损斑块组		32（50.8）			19（30.2）			26（41.3）			22（34.9）
稳定斑块组		16（43.2）			10（27.0）			12（32.4）			11（29.7）
χ²		0.532			0.111			0.773			0.284
组别			高血脂史			SBP/mmHg				DBP/mmHg
易损斑块组			37（58.7）			131.28±13.05				81.52±7.54
稳定斑块组			20（54.1）			127.39±12.28				79.64±9.15
χ²或t			0.208			1.470				1.111

组别	n		TC/（mmol/L）	TG/（mmol/L）		LDL-C/（mmol/L）
易损斑块组	63		4.51±1.05	1.64±0.55		3.05±0.72
稳定斑块组	37		4.43±1.13	1.57±0.62		2.84±0.84
t			0.358	0.586		1.323
组别		HDL-C/（mmol/L）			S100B/（µg/L）		GFAP/（ng/L）
易损斑块组		1.48±0.31			3.14±0.52		75.25±14.69
稳定斑块组		1.39±0.35			2.56±0.43		56.07±10.08
t		1.336			5.728^＊＊		7.023^＊＊

组别	n		TC/（mmol/L）	TG/（mmol/L）		LDL-C/（mmol/L）
易损斑块组	63		4.51±1.05	1.64±0.55		3.05±0.72
稳定斑块组	37		4.43±1.13	1.57±0.62		2.84±0.84
t			0.358	0.586		1.323
组别		HDL-C/（mmol/L）			S100B/（µg/L）		GFAP/（ng/L）
易损斑块组		1.48±0.31			3.14±0.52		75.25±14.69
稳定斑块组		1.39±0.35			2.56±0.43		56.07±10.08
t		1.336			5.728^＊＊		7.023^＊＊

变量	β	SE	Wald χ²	P	OR	OR（95%CI）
S100B	3.918	0.961	16.605	<0.001	50.286	7.648~330.815
GFAP	0.153	0.036	18.338	<0.001	1.165	1.086~1.251
常数项	-20.139	4.447	20.513	<0.001	0.000	-

超声联合血清S100B及神经胶质纤维酸性蛋白水平评估颈动脉易损斑块的临床价值

Clinical value of ultrasound and serum S100B combined with glial fibrillary acidic protein in evaluating carotid vulnerable plaque

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变量	AUC	95%CI	敏感度/ %	特异度/ %	截断值	约登指数
S100B	0.820	0.731~0.890	76.19	83.78	2.94	0.600
GFAP	0.855	0.771~0.918	73.02	86.49	66.87	0.595
超声结果	0.874	0.792~0.932	93.65	81.08	-	0.747
三者联合	0.918	0.846~0.964	73.02	97.30	-	0.703

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