Study On The Correlation Between Neovascularization In Carotid Plaque And Plaque Hardness,Blood Neutrophil/lymphocyte Ratio And Serum Total Bilirubin Levels

Objectives This study aims to analyze the correlation between mean elastic modulus(Em),neutrophil to lymphocyte ratio(NLR),serum total bilirubin(STB)and neovascularization in carotid plaques,and to explore the clinical value of Em,NLR and STB in assessing plaque vulnerability.Methods A total of sixty-seven patients with carotid atherosclerotic plaque who had been treated in Hebei Provincial People’s hospital from January 2020 to December 2020were collected.All the enrolled patients were selected according to the inclusion and exclusion criteria.Sixty-seven patients with carotid atherosclerosis were identified to use the routine color Doppler,and further examined using superb micro-vascular imaging(SMI)and shear wave elastography imaging(SWE).The general clinical data,other imaging data and laboratory examination results were collected on patients.Patients were divided into two groups according to SMI: group without neovascularization(group A)and group with neovascularization(group B).Patients age,sex,body mass index(BMI),the prevalence of cardiovascular and cerebrovascular disease(CVD),the plaque thickness,plaque echo,the elastic modulus(Em)value,degree of vascular stenosis caused by blood,blood cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),high-density lipoprotein(HDL),serum total bilirubin(STB),white blood cell count(WBC),neutrophil count(NEUT),lymphocyte count(LY),blood neutrophil/lymphocyte ratio(NLR)were compared between the two groups.Multivariate regression analysis was used to analyze the risk factors of intraplaque neovascularization(IPN).Group B was divided into B1,B2 and B3 groups according to SMI grade 1,2 and3,and the differences of the above variables were compared among the three groups.In addition,the correlation between SMI grade and NLR,STB and Em was analyzed.According to the difference of plaque echo,the plaques were divided into three groups:low echo plaque group(LP),mixed echo plaque group(MP)and iso-echo plaque group(IP).Em values and neovascularization were compared between the three groups.Results Comparison of patients with and without neovascularization group showed that there were statistical differences in cardiovascular and cerebrovascular disease,plaque echo,plaque thickness,Em value,degree of vascular stenosis,TC,LDL,STB,WBC,NEUT and NLR between the two groups(all P<0.05);Among them,NLR is an independent risk factor for neovascularization in plaques,STB is the protective factor.By comparing the related indicators of patients with different grades of SMI,it was found that there were significant differences in TG,HDL,LDL,STB,WBC,NLR and Em among the three groups(all P<0.05);Young’s modulus values and STB were negatively correlated with SMI classification,while NLR was positively correlated with SMI classification.There were statistically significant differences in plaque hardness and neovascularization among three groups of different echogenic plaques(all P<0.05).Conclusions First,the Em value of carotid atherosclerosis patients is negatively correlated with the number of neovascularization in the plaque,which could provide a reference for evaluating the vulnerability of plaque.Second,the levels of NLR and STB in patients with carotid artery plaques are correlated with the number of neovascularization in the plaque,which can indicate the formation of vulnerable plaques,and these indicators should be paid close attention.Third,high level of NLR and low level of STB are independent risk factors for the formation of neovascularization in plaque.Figure 7;Table 8;Reference 90...