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

doi:10.11958/20253193

Abstract

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

CLC Number:

R445.1

Figures/Tables 6

References 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	-