Gemstone Spectral Imaging Combined With Serum HMGB1、Hs-CRP Preliminary Study On Carotid Atherosclerosis Plaque

Objectives:Preliminary screening on the carotid plaque with CDFI, energy spectrum analysis and quantitative determination of calcium and lipid content ratio on the plaque by GSI,combined with the difference of serum HMGB1, Hs-CRP, to further explore serum HMGB1, Hs-CRP in the role of plaque vulnerability.Methods:100 patients with carotid artery plaques were selected from CDFI, and 49 patients with confirmed plaques were further diagnosed by GSI. These 49 patients constitute the case group,divided it into the vulnerable plaque group(21 cases) and steady plaque group(28 cases) through energy spectrum analysis,later, the relative content of calcium on lipid of 49 case group patients was measured.20 patients with normal carotid artery by CDFI as the matched group. All the 69 patients were left serum sample, HMGB1 concentration and Hs-CRP concentration in serum were mensurated by immunoassay.Results:1.Energy spectrum analysis showed that, compared with the vulnerable plaque group, steady plaque group contains more calcium.Compared with the steady plaque group, vulnerable plaque group contains more lipid.The intraplaque calcium and lipid relative concentration(g/L) of plaques in vulnerable plaque group and steady plaque group were 0.205(0.042,0.207)、 0.227(0.225,0.228).The intraplaque calcium and lipid relative concentration of vulnerable plaque group was lower than that of steadyplaque group,the difference was statistical significant(p<0.001).2.GSI detected 21 cases of vulnerable plaques and 28 cases of steady plaques in all.In the vulnerable plaque group,common carotid artery segment has 7 cases(33.3%), common carotid crotch has 11 cases(52.4%) and external carotid artery has3 cases(14.3%).In the steady plaque group,common carotid artery segment has 11patients(39.3%), common carotid crotch has15 patients(53.6%) and 2 cases(7.1%)come from external carotid artery.3.HMGB1(ng/ml) in serum of vulnerable plaque group,steady plaque group and matched group were 2.19(1.98,2.87)、 2.00(1.78,2.50)、 0.68(0.34,0.93). The serum HMGB1 level of plaque group was higher than that of matched group, the difference was significant(p<0.001).The serum HMGB1 level of of vulnerable plaque group was higher than that of steady plaque group,no statistically significant(p=0.1633).4.Hs-CRP(mg/L) in serum of vulnerable plaque group,steady plaque group and matched group were 4.28(3.76,5.45)、1.41(1.21,1.67)、0.39(0.18,0.66);The serum Hs-CRP level of vulnerable plaque group was higher than that of the other two groups,Hs-CRP level of steady plaque group was higher than that of matched group, the results of the above two was significant(p<0.001).5.Serum HMGB1 and intraplaque calcium and lipid relative concentration was not related(r=-0.10654,p=0.4662).Serum HMGB1 was positively associated with serum Hs-CRP(r=0.73443,p<0.001).Serum Hs-CRP was negatively associated with intraplaque calcium and lipid relative concentration(r=-0.71367,p<0.001).Conclusions:1.GSI has amazing ability in energy spectrum analysis and quantitative determination of the relative content of calcium on lipid in the plaque.2.The serum levels of HMGB1 may be involved in plaque’s generation,the role of HMGB1 in plaque vulnerability is not clear.3.The serum levels of Hs-CRP may be related to sequential progression ofatherosclerosis, and elevated Hs-CRP shows that plaque is highly prone to rup ture.4.The serum HMGB1 and Hs-CRP are involved in the mechanism of pathological inflammatory damage of atherosclerosis.