血清血小板源性生长因子与冠状动脉粥样硬化斑块超声显像特征的关系研究

发布时间：2018-04-22 15:12

本文选题：冠状动脉疾病 + 血小板源性生长因子　；参考：《中国循环杂志》2017年06期

【摘要】：目的:采用血管内超声(IVUS)技术检测不同类型冠心病患者冠状动脉内粥样硬化斑块的性质及其与血清血小板源性生长因子(PDGF)的关系研究。方法:选取2011-01至2013-10期间胜利油田中心医院住院并行冠状动脉造影检查的患者106例作为研究对象,其中急性冠状动脉综合征患者(ACS组)60例,稳定性心绞痛患者(SAP组)46例。记录患者性别、年龄、吸烟史、高血压病史、糖尿病病史等基本资料,采用双抗体夹心酶联免疫吸附法(ELISA法)检测患者血清PDGF水平。同时对两组患者进行IVUS检查,详细记录罪犯血管最狭窄处冠状动脉粥样斑块形态、性质、斑块破裂、血栓形成、重构情况以及病变处外弹力膜面积、管腔面积、斑块面积、偏心指数等。比较两组斑块性质、斑块破裂和血栓形成发生率、正性重构比率以及外弹力膜面积、偏心指数等的差异,以及不同斑块性质血清PDGF水平的差异。结果:(1)SAP组血清PDGF浓度为(3.64±0.60)ng/L显著高于ACS组(2.12±0.51)ng/L,两组比较差异有统计学意义(P0.05)。(2)SAP组患者冠状动脉病变以硬斑块为主,ACS组患者斑块以软斑块为主。与SAP组比较,ACS组患者斑块破裂、血栓形成、正性重构发生率高,且ACS组较SAP组斑块以偏心斑块为主,偏心指数低,差异均有统计学意义(P0.05~0.01)。与SAP组比较,ACS组患者病变血管外弹力膜面积较大,差异有统计学差异(P0.01)。(3)纤维斑块、钙化斑块、混合斑块(硬斑块)血清PDGF水平均低于软斑块,差异有统计学意义(P0.05~0.01)。结论:PDGF参与冠状动脉粥样硬化斑块的形成,在ACS的发病中起着重要作用,斑块越不稳定,PDGF的浓度越高,检测血清PDGF水平有助于诊断和预测ACS的发生,使ACS的诊断流程和治疗策略的选择更趋于合理和规范。
[Abstract]:Objective: to study the relationship between the characteristics of coronary atherosclerotic plaque and serum platelet derived growth factor (PDGF) in patients with coronary artery disease (CHD) by intravascular ultrasound (IVUSS). Methods: 106 patients with acute coronary syndrome (ACS) and stable angina pectoris (SAP) in Shengli Oilfield Central Hospital underwent coronary angiography from January 2011 to October 2013-10 were selected as the study subjects, including 60 patients with acute coronary syndrome (ACS) and 46 patients with stable angina pectoris (SAP). Sex, age, smoking history, hypertension history, diabetes history and other basic data were recorded. The serum PDGF level was detected by double antibody sandwich enzyme-linked immunosorbent assay (Elisa). At the same time, two groups of patients were examined by IVUS. The morphology, nature, plaque rupture, thrombus formation, remodeling and the area of external elastic membrane, lumen and plaque of coronary atherosclerotic plaque were recorded in detail. Eccentricity index, etc. The characteristics of plaque, the incidence of plaque rupture and thrombosis, the ratio of positive remodeling, the area of outer elastic membrane and eccentricity index, and the difference of serum PDGF level between the two groups were compared. Results the serum PDGF concentration in the SAP group was 3.64 卤0.60)ng/L significantly higher than that in the ACS group (2.12 卤0.51ng / L). The difference between the two groups was statistically significant (P 0.05). Compared with SAP group, the incidence of plaque rupture, thrombosis and positive remodeling in ACS group was higher than that in SAP group, and the eccentricity index was lower in ACS group than in SAP group. Compared with the SAP group, the area of the diseased extravascular elastic membrane in the SAP group was larger than that in the control group, and the difference was statistically significant (P 0.01). The levels of serum PDGF in calcified plaques and mixed plaques (hard plaques) were lower than those in the soft plaques (P 0.05 0. 01), and the difference was statistically significant (P 0. 05 0. 01). Conclusion the presence of ACS in coronary atherosclerotic plaque may play an important role in the pathogenesis of ACS. The higher the concentration of PDGF in plaque is, the higher the concentration of PDGF is. The detection of serum PDGF level is helpful to diagnose and predict the occurrence of ACS. The diagnosis process and treatment strategy of ACS are more reasonable and standardized.
【作者单位】：胜利油田中心医院内科;
【基金】：山东省医药卫生科技发展计划项目(2011HW075)
【分类号】：R541.4

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