血清脂蛋白相关磷脂酶A2水平与冠脉斑块成分的相关性分析

发布时间：2018-02-01 15:36

本文关键词： 血管内超声血清脂蛋白相关磷脂酶A2 冠心病　出处：《郑州大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的采用血管内超声-虚拟组织学成像技术(VH-IVUS)对冠心病患者的斑块进行分析,并明确斑块性质和血清脂蛋白相关磷脂酶A2.(Lipoprotein-associated phospholipase A2.Lp-PLA2)之间的相关程度。方法1、根据标准挑选有冠心病的病人总人数为115人,稳定型心绞痛(Stable Angina,SA)病人为54人,急性冠脉综合征(Acute Coronary Syndrome,ACS)的病人占61人,空白对照组则为52人,明确诊断。2、对造影过程中选取的目标行血管内超声检查,并记录检查的结果及灰阶图像以利于后期分析和研究。3、通过检测得到研究对象血清脂蛋白相关磷脂酶A2、超敏C-反应蛋白.(high sensitivity C-reactive protein)等常规血液指标的水平。4、通过统计手段对血清脂蛋白相关磷脂酶A2、超敏C-反应蛋白与斑块成分进行相关性分析。结果1三组患者的一般情况不存在统计学上的差异;2 VH-IVUS结果显示:ACS组血管重塑指数、坏死核心(necrotic core,NC)、斑块偏心指数均高于SA组,差异有统计学意义(P0.05),斑块中FF与纤维组织(fibrous tissue,FT)比例均低于SA组,差异有统计学差异(P0.05)3 ACS组患者血清脂蛋白相关磷脂酶A2、超敏C-反应蛋白水平明显高于SA组及对照组,差异有统计学意义(P0.05)4 ACS组血清Lp-PLA2水平与斑块中NC所占比例、血管重塑指数、斑块偏心指数呈正相关(r=0.736,P=0.016;r=0.651,P=0.024;r=0.719,P=0.027)。结论1、ACS患者中偏心性斑块占多数且斑块中NC比例高,SA斑块中纤维组织及纤维脂肪组织占多数;2、以下指标:(1)NC比例(2)斑块偏心指数(3)血管重构指数与血清脂蛋白相关磷脂酶A2、hs-CRP等指标之间存在呈显著正相关关系。3、血清脂蛋白相关磷脂酶A2对于判断冠心病病人斑块稳定性方面具有较为可靠的预测作用。
[Abstract]:Objective to study imaging technique using intravascular ultrasound virtual organization (VH-IVUS) on patients with coronary heart disease and plaque analysis, clear plaque and serum lipoprotein associated phospholipase A2. (Lipoprotein-associated phospholipase A2.Lp-PLA2). The degree of correlation between the 1 methods, according to the total number of standard selection of patients with coronary heart disease was 115, stable angina pectoris (Stable Angina, SA) for 54 patients, acute coronary syndrome (Acute Coronary, Syndrome, ACS) patients accounted for 61, while the control group was 52, the diagnosis of.2, the target selection in the process of vascular contrast ultrasound, and record the inspection results and the gray-scale image for later the analysis and study of.3, obtained the research object of serum lipoprotein associated phospholipase A2 through detection, high sensitivity C- reactive protein (high sensitivity C-reactive protein). The level of.4 and other conventional blood indexes, through Statistical methods of serum lipoprotein associated phospholipase A2, high sensitive C- reactive protein and plaque composition were analyzed. Results 1 patients of the three groups in general, there was not statistical difference; 2 VH-IVUS results showed: ACS group of vascular remodeling index, necrotic core (necrotic core, NC), plaque eccentricity index were higher than that of group SA, the difference was statistically significant (P0.05), FF and fiber (fibrous tissue, FT plaque) ratio were lower than SA group, there was significant difference (P0.05) of 3 ACS patients serum lipoprotein associated phospholipase A2, hypersensitive C- reaction protein level was significantly higher than that of SA group and control group, the difference was statistically significant (P0.05) 4 ACS group, serum Lp-PLA2 level and plaque in the proportion of NC, vascular remodeling index and plaque index were positively related to eccentricity (r=0.736, P=0.016; r=0.651, P=0.024; r=0.719, P=0.027). Conclusion: 1, ACS in patients with eccentric plaque and plaque majority Block NC in high proportion, fibrous tissue and adipose tissue SA fiber plaque in the majority; 2, the following indicators: (1) the proportion of NC (2) plaque eccentricity index (3) vascular remodeling index and lipoprotein associated phospholipase A2, there was a significant positive correlation between.3 hs-CRP and other indicators, serum lipoprotein associated phospholipase A2 has forecast effect is reliable for judging the stability of plaque in patients with coronary heart disease.

【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4

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