目的 应用颈动脉超声造影（CEUS）技术半定量评估斑块内新生血管（IPN），探讨基质金属蛋 白酶⁃9（MMP⁃9）启动子基因⁃1562C/T 变异、MMP⁃9 与基质金属蛋白酶组织抑制剂⁃1 比值（MMP⁃9/TIMP⁃1） 对 IPN 的影响。方法 纳入 180 例颈动脉粥样硬化斑块患者，应用 CEUS 评估 IPN 分级并分组。ELISA 法检测血清 MMP⁃9、TIMP⁃1 水平，Sanger 法对基因测序；应用相关性分析及 logistic 回归分析各参数对 IPN 的影响并绘制 ROC 曲线。结果 血清 MMP⁃9、MMP⁃91562C/T 变异、MMP⁃9/TIMP⁃1 比值与 IPN 超声造影分 级呈正相关（r = 0.332，r = 0.238，r = 0.683，P < 0.001），logistic 回归显示 MMP⁃9/TIMP⁃1 比例失衡是 IPN 独立 危险因素（OR = 6.110，95%CI：1.097 ~ 34.033，P = 0.039），MMP⁃9/TIMP⁃1 比值≥ 2.12，IPN 超声造影分级≥ Ⅲ级的 AUC 为 0.89，敏感度为 84.90%，特异度为 85.10%。结论 MMP⁃9 酶抑制剂调控 MMP⁃9/TIMP⁃1 比例 失衡是 IPN 独立危险因素。IPN 超声造影视觉分级结合 MMP⁃9/TIMP⁃1 比值作适当调整，可较准确评估易 损斑块。

Objective To investigate the correlation of matrix metalloproteinase ⁃ 9（MMP ⁃ 9）promoter gene⁃1562C/T mutation，MMP⁃9/TIMP⁃1 ratio and intraplaque neovessels（IPN）which were semi⁃quantitatively assessed by contrast⁃enhanced ultrasound（CEUS）. Methods A total of 180 subjects with carotid atherosclerotic plaques were selected and grouped according to IPN grading. The IPN grading was semi⁃quantitatively assessed by CEUS. The ELISA measure was utilized to examine serum MMP⁃9 and TIMP⁃1 levels. Gene sequence was detected by the Sanger measure. Correlation analysis and logistic regression were employed to analyze the effect of each parameter on IPN，and then receiver operating characteristic（ROC）curve was constructed. Results MMP⁃9 serum concentration，MMP⁃91562C/T mutation，MMP⁃9/TIMP⁃1 were positively correlated with IPN grading（r = 0.332， r =0.238，r = 0.683，P < 0.001）. Logistic regression indicated that the imbalance of MMP ⁃9/TIMP ⁃1 proportion was an independent risk factor for IPN（OR = 6.110，95%CI 1.097 ~ 34.033，P = 0.039）. If MMP⁃9/TIMP⁃1 ≥ 2.12，the area under ROC curve of IPN grading ≥ Ⅲ was 0.89，the sensitivity was 84.90% and the specificity was 85.10%. Conclusion The imbalance of MMP⁃9/TIMP⁃1 proportion may be an independent risk factor for IPN. The appropriate adjustment of IPN contrast ⁃ enhanced ultrasound visual grading combining with MMP ⁃ 9/TIMP ⁃1 was beneficial for identification of vulnerable plaques.