心绞痛斑块血管内超声特征与血清炎性因子的相关性

发布时间：2018-03-28 13:23

本文选题：心绞痛　切入点：血管内超声　出处：《中国老年学杂志》2017年09期

【摘要】：目的探讨心绞痛斑块中血管内超声(IVVS)特征与血清炎性因子的特点及相关性。方法 46例冠心病心绞痛患者按美国心脏协会(AHA)诊断标准和心绞痛症状分为不稳定型心绞痛组(n=27)和稳定型心绞痛组(n=19)。检测两组高敏C反应蛋白(hs CRP)和IVUS相关指标。结果稳定型心绞痛组狭窄处病变主要为混合性和纤维性斑块,而不稳定型心绞痛组狭窄处病变主要为脂质斑块。两组病变部位的管腔面积(LA)差异无统计学意义(P0.05),而斑块部位的LA狭窄率(LAS)、偏心指数(EI)、斑块面积(PA)及血管外弹力膜面积(EEMA)差异有统计学意义(P0.05),病变参考部位血管段LAS、重构指数(RI)、PA、LA、EEMA对比差异无统计学意义(P0.05)。稳定型心绞痛组中有12例为负性重构;不稳定型心绞痛组中有17例为正性重构。两组血清中hs CRP水平对比差异有统计学意义(P0.05),不稳定型心绞痛患者中IVUS的EEMA和RI与hs CRP呈正相关(r=0.565,P0.05)。结论血栓形成和斑块破裂是不稳定心绞痛的重要发病机制,同时炎症反应是心绞痛患者血管重构的重要因素。不稳定型心绞痛病情变化的敏感标志物主要有血清中的hs CRP,不稳定斑块伴有正性重构、较大的斑块面积和偏心分布的低回声脂质斑块。
[Abstract]:Objective to investigate the relationship between the characteristics of intravascular ultrasound IVVSand serum inflammatory factors in patients with angina pectoris. Methods 46 patients with angina pectoris were classified into unstable type according to the diagnostic criteria of American Heart Association (AHAA) and the symptoms of angina pectoris. The relative indexes of Gao Min C-reactive protein hs (hs) and IVUS were detected. Results the stenosis lesions were mainly mixed and fibrous plaques in stable angina pectoris group and stable angina pectoris group. There was no significant difference in lumen area between the two groups (P 0.05), but the LA stenosis rate of plaque site was LASA, eccentricity index, plaque area, and extravascular elasticity. There was no significant difference in membrane area (EEMAA) between two groups (P 0.05), and there was no significant difference in vascular segment LASand remodeling index between two groups (P 0.05). There were 12 cases of negative remodeling in stable angina pectoris group. There were 17 cases of positive remodeling in unstable angina pectoris group. There was significant difference in serum hs CRP level between the two groups. The EEMA and RI of IVUS were positively correlated with HS CRP in patients with unstable angina pectoris. Conclusion Thrombosis and plaque are associated with P0.05in the patients with unstable angina pectoris. Rupture is an important pathogenesis of unstable angina pectoris. Inflammation is also an important factor in vascular remodeling in patients with angina pectoris. The sensitive markers of the changes of unstable angina pectoris are hs CRP in serum, and unstable plaques with positive remodeling. Large plaque area and eccentric distribution of low echo lipid plaque.
【作者单位】：辽宁省人民医院心功能科;辽宁省人民医院心内科;
【分类号】：R445.1;R541.4

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