Correlation of dietary inflammatory index and carotid plaque enhancement by contrastenhanced ultrasonography
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摘要:
目的探讨超声造影对膳食炎症指数（DII）与颈动脉斑块内增强特征的相关性。 方法选取2015年3月~2019年10月在我院行颈动脉斑块复查的77例患者作为研究对象。采用食物频率问卷表调查患者的日常饮食数据，应用膳食营养软件计算食物的膳食成分/营养素的DII指数。根据患者DII指数分组，即DII指数为正数纳入促炎饮食组（n=35），DII指数为负数纳入抗炎饮食组（n=42）；并根据患者DII指数划分5个等级，即≤-1.05、-1.05~-0.33、-0.33~0.38、0.38~1.22、≥1.22。采用彩色多普勒超声检测患者颈动脉斑块，对其斑块厚度、回声类型、斑块造影剂分布特征进行分析。双变量相关性分析采用Kendall相关系数法检验。 结果促炎饮食组35例患者共41枚斑块，抗炎饮食组42例患者共47枚斑块。促炎饮食组的斑块厚度较抗炎饮食组的增厚，差异有统计学意义（P < 0.05）；促炎饮食组超声造影增强多于抗炎饮食组，差异有统计学意义（P < 0.05）。DII指数与颈动脉斑块内膜有无增强呈显著性正相关（Kendall相关系数为0.659，P < 0.001）。 结论促炎饮食患者的颈动脉斑块较厚，DII指数越高，颈动脉斑块斑块内增强特征越明显。 Abstract:ObjectiveTo explore the correlation between dietary inflammatory index (DII) and enhancement characteristics of carotid plaque by contrast-enhanced ultrasound. MethodsFrom March 2015 to October 2019, 77 patients with carotid plaque reexamined in our hospital were selected as the study objects. Food frequency questionnaire was used to collect the data of patients' daily diet, The DiI index of dietary components/nutrients of food was calculated by dietary nutrition software. According to the DiI index of patients, the positive DiI index (35 cases) was included in the anti-inflammatory diet group, and the negative DiI index (42 cases) was included in the anti-inflammatory diet group. According to the DiI index of patients, 5 grades were divided, That is ≤-1.05, -1.05~-0.33, -0.33~0.38, 0.38~ < 1.22 and ≥1.22. Carotid plaque was detected by color Doppler ultrasound. The plaque thickness, echo type and the distribution of plaque contrast agent were analyzed. Kendall correlation coefficient method was used to test the bivariate correlation analysis. ResultsThere were 41 plaques in 35 patients in the pro-inflammatory diet group and 47 plaques in 42 patients in the anti-inflammatory diet group. Inflammation promoting diet group of plaque thickness relatively anti-inflammatory diet group of thickening. The difference was statistically significant (P < 0.05). Inflammation promoting diet group contrast enhanced ultrasound enhance many to antiinflammatory diet group. The difference was statistically significant (P < 0.05). There was a significant positive correlation between DiI index and carotid plaque intima enhancement (Kendall correlation coefficient 0.659, P < 0.001). ConclusionsCarotid plaques are quite thick in patients with pro-inflammatory diet. The higher the DiI index, the more obvious the enhancement characteristics of carotid plaque. -
Key words:
- contrast-enhanced ultrasound /
- dietary inflammation index /
- carotid plaque
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图 1 颈动脉斑块CEUS图像
A: 促炎饮食组患者, 男, 66岁, 颈动脉分叉处斑块造影2级增强, 斑块内弥漫性增强（圈处）; B:抗炎饮食组患者, 男, 67岁, 颈动脉分叉处斑块造影1级 增强, 近基底部点状增强（圈处）
Figure 1. Contrast-enhanced ultrasound image of carotid plaque
表 1 促炎饮食组与抗炎饮食组的一般资料对比[n(%), Mean±SD]
Table 1. Comparison of general data between the pro-inflammatory diet group and the anti-inflammatory diet group
组别 性别(男/女） 年龄(岁） BMI(kg/m2) 血糖(mmol/L) 舒张压(mmHg) 收缩压(mmHg) 促炎饮食组(n=35) 30/5 62.89± 9.17 24.58土2.09 5.31±0.76 76.98± 7.47 121.47±6.98 抗炎饮食组(n=42) 34/8 64.79± 8.96 24.63± 2.12 5.16 ± 0.73 77.45土7.22 122.75±7.16 t 0.308 0.916 0.103 0.881 0.280 0.790 P 0.579 0.362 0.917 0.381 0.780 0.432 
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表 2 两组斑块厚度及回声类型比较[n(%)]
Table 2. Comparison of patch thickness and echo type between two groups
组别 斑块数(n) 斑块厚度(mm，Mean±SD) 回声类型 混合回声 等回声 低回声 促炎饮食组(n=35) 41 4.12±1.03 27(65.85) 9(21.95) 5(12.20) 抗炎饮食组(n=42) 47 3.69±0.95 26(55.32) 17(36.17) 4(8.51) t/χ2 2.037 2.193 P 0.045 0.334
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表 3 两组CEUS检查结果比较[n(%)]
Table 3. Comparison of contrast-enhanced ultrasonography results between two groups
组别 斑块数(n) 0级 1级 2级 促炎饮食组(n=35) 41 2(4.88) 17(41.46) 22(53.66) 抗炎饮食组(n=42) 47 7(14.89) 27(57.45) 13(27.66) t/χ2 2.392 2.238 6.179 P 0.122 0.135 0.013
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表 4 DII指数与颈动脉斑块内增强的相关性分析（n）
Table 4. CorrelationAnalysis of DiI index and carotid plaque internal enhancement
DII指数等级（分） 颈动脉斑块内增强 合计 + - ≤-1.05 2 26 28 -1.05~-0.33 4 13 17 -0.33~0.38 5 10 15 0.38~1.22 11 3 14 ≥1.22 13 1 14 合计 35 53 88
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