超微细血管成像技术联合血清IL-17、MMP-9、PTX3评估多发性大动脉炎病情活动性的价值分析*

doi:10.3870/j.issn.1672-0741.25.09.044

摘要/Abstract

摘要： 目的分析超微细血管成像(superb microvascular imaging,SMI)技术联合血清白介素-17(IL-17)、基质金属蛋白酶-9(MMP-9)、正五聚体蛋白-3(PTX3)评估多发性大动脉炎(Takayasu's arteritis,TA)病情活动性的价值。方法选取2020年4月~2024年11月期间于河北省人民医院就诊的TA患者52例为研究对象,其中活动期29例,非活动期23例。比较两组患者临床资料;使用东芝Aplio 500彩色多普勒超声诊断仪,观察患者颈动脉中增厚管壁内的血管情况;采用酶联免疫吸附实验检测血清IL-17、MMP-9及PTX3水平;比较活动期组与非活动期组患者SMI分级结果及血清指标水平。采用Spearman等级相关分析评估SMI分级与血清IL-17、MMP-9、PTX3的相关性;采用受试者工作特征(ROC)曲线分析SMI分级和血清IL-17、MMP-9、PTX3单独或联合应用对TA患者病情活动性的评估价值。结果活动期组与非活动期组患者在年龄、性别构成、身体质量指数(BMI)、病程、临床症状、受累颈动脉等方面的差异均无统计学意义(均P＞0.05);与非活动期组相比,活动期组患者血清IL-17、MMP-9、PTX3水平均明显升高,且两组SMI分级存在显著差异(均P＜0.05);Spearman相关分析结果显示,SMI分级与IL-17、MMP-9、PTX3均呈正相关(r=0.418、0.502、0.459,均P＜0.01);ROC曲线分析结果显示,SMI分级、血清IL-17、MMP-9及PTX3评估TA患者病情活动性的曲线下面积(AUC)分别为0.849、0.723、0.835、0.817,四者联合评估的AUC为0.949,高于单独预测(Z=2.044,P=0.041;Z=3.061,P=0.002;Z=2.050,P=0.040;Z=2.446,P=0.014),敏感度和特异度分别为86.21%、91.30%。结论 SMI分级与血清IL-17、MMP-9、PTX3均可用于评估TA病情活动性,联合应用时价值更高。

关键词: 超微细血管成像, 多发性大动脉炎, 白介素-17, 基质金属蛋白酶-9, 正五聚体蛋白-3

Abstract: Objective To evaluate the diagnostic value of superb microvascular imaging(SMI)combined with serum interleukin-17(IL-17),matrix metalloproteinase-9(MMP-9),and pentraxin-3(PTX3)in assessing disease activity of Takayasu's arteritis(TA). Methods A total of 52 TA patients treated at our hospital between April 2020 and November 2024 were enrolled,including 29 with active disease and 23 with inactive disease.Clinical data were compared between the two groups.Vascular assessments of thickened arterial walls were performed by the Toshiba Aplio 500 color Doppler ultrasound system.Serum levels of IL-17,MMP-9,and PTX3 were detected by enzyme-linked immunosorbent assay.SMI grades and serum biomarker levels were compared between the active and inactive groups.Spearman's rank correlation analysis was used to assess the correlation between SMI grade and serum IL-17,MMP-9,and PTX3 levels.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the individual and combined value of SMI grade and serum biomarkers for disease activity of TA patients. Results No significant differences were observed between the active and inactive groups in terms of age,sex composition,body mass index(BMI),disease duration,clinical symptoms,or carotid artery involvement(all P>0.05).Compared with the inactive group,the active group exhibited significantly higher levels of serum IL-17,MMP-9,and PTX3,as well as a distinct distribution of SMI grade(all P<0.05).Spearman's analysis showed that SMI grade was positively correlated with IL-17,MMP-9,and PTX3 levels(r=0.418,0.502,0.459,all P<0.01).ROC curve analysis showed that the area under the curve(AUC)for SMI grade,serum IL-17,MMP-9,and PTX3 in assessing the disease activity was 0.849,0.723,0.835,and 0.817,respectively.The combined assessment of all four indicators yielded an AUC of 0.949,which was significantly higher than that of any single indicator(Z=2.044,P=0.041;Z=3.061,P=0.002;Z=2.050,P=0.040;Z=2.446,P=0.014),with a sensitivity of 86.21% and specificity of 91.30%. Conclusion SMI grading,alone or combined with serum IL-17,MMP-9,and PTX3,is useful for evaluating disease activity of TA,with enhanced diagnostic performance when used together.

Key words: superb microvascular imaging, Takayasu's arteritis, interleukin-17, matrix metalloproteinase-9, pentraxin-3

中图分类号:

陈敏, 牛慧敏, 刘欣, 高洁. 超微细血管成像技术联合血清IL-17、MMP-9、PTX3评估多发性大动脉炎病情活动性的价值分析^*[J]. 华中科技大学学报（医学版）, 2026, 55(2): 258-262.

Chen Min, Niu Huimin, Liu Xin et al. Value of Superb Microvascular Imaging Combined with Serum IL-17,MMP-9, andPTX3 in Assessing Disease Activity of Takayasu's Arteritis[J]. Acta Medicinae Universitatis Scientiae et Technologiae Huazhong, 2026, 55(2): 258-262.

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超微细血管成像技术联合血清IL-17、MMP-9、PTX3评估多发性大动脉炎病情活动性的价值分析^*

Value of Superb Microvascular Imaging Combined with Serum IL-17,MMP-9, andPTX3 in Assessing Disease Activity of Takayasu's Arteritis

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