Diagnostic evaluation of blood lipid profile combined with CT angiography for carotid plaque in patients with cerebral infarction

Dai Yunjiao; Liu Xiaocui; Ren Qianyu; Xu Wenli

doi:10.3760/j.issn.1673-4777.2025.09.008

Abstract：Objective To investigate the application value of profile blood lipid combined with CT angiography(CTA)in the diagnosis of carotid plaque in patients with cerebral infarction.Methods A total of 200 patients with cerebral infarction admitted to the Department of Neurology,Zhangjiakou First Hospital,Hebei Province from May 2021 to December 2022 were selected as the observation group,and 100 healthy people who underwent physical examination during the same period were selected as the control group.According to the results of digital subtraction angiography,the patients in the observation group were divided into plaque group(108 cases)and non-plaque group(92 cases).Gender,age,smoking history,hypertension,diabetes,heart disease history,kidney disease history,and blood lipid indexes were collected and compared.The results of digital subtraction angiography were used as the gold standard to evaluate the efficacy of CTA alone and combined with blood lipid indexes in the diagnosis of carotid plaque.Results There were no statistically significant differences in baseline data between the observation group and the control group(all P＞0.05).The levels of serum matrix metalloproteinase-9(MMP-9),total cholesterol,triglyceride and low-density lipoprotein cholesterol(LDL-C)in the observation group were higher than those in the control group,and the levels of tissue inhibitor of metalloproteinase-1(TIMP-1)and high-density lipoprotein cholesterol(HDL-C)were lower than those in the control group(all P＜0.05).The levels of serum MMP-9,total cholesterol,triglyceride and LDL-C in the plaque group were higher than those in the non-plaque group,and the levels of TIMP-1 and HDL-C in the plaque group were lower than those in the non-plaque group(all P＜0.05).Multivariate Logistic regression showed that MMP-9 and triglyceride were independent risk factors for carotid plaque,and TIMP-1 was protective factor(all P＜0.05).The area under the curve(AUC)of CTA combined with serum MMP-9,TIMP-1,total cholesterol,triglyceride,HDL-C and LDL-C in the diagnosis of carotid plaque was 0.993.The AUC of CTA combined with serum MMP-9 and TIMP-1 in the diagnosis of carotid plaque was 0.981.The AUC of CTA alone in the diagnosis of carotid plaque was 0.935,and the diagnostic efficacy of combined diagnosis was higher than that of CTA alone.Conclusion Blood lipid profile combined with CTA,MMP-9 and TIMP-1 can significantly improve the diagnostic efficiency of carotid plaque in patients with cerebral infarction,provide a more comprehensive and accurate diagnostic basis for clinical practice,and contribute to early intervention and individualized treatment of cerebral infarction.