OCT检测冠状动脉斑块特征及其与基质金属蛋白酶相关性研究

发布时间：2018-06-13 03:47

本文选题：冠心病 + 不稳定斑块　；参考：《重庆医学》2017年17期

【摘要】：目的采用冠状动脉内光学相干断层扫描(OCT)检测冠状动脉粥样硬化斑块特征及其与血清基质金属蛋白酶(MMP)7、MMP9、MMP12水平的关系。方法选择2014年10月至2016年3月拟行冠状动脉造影明确冠状动脉病变的患者,根据OCT检测结果分为稳定斑块组和不稳定斑块组。应用OCT检测斑块的纤维帽厚度、脂质池角度、巨噬细胞浸润、斑块裂隙、斑块内新生血管等特征。搜集研究对象基本资料,采用酶联免疫吸附试验(ELISA)检测血清MMP7、MMP9、MMP12水平。结果 (1)稳定斑块组纤维帽厚度大于不稳定斑块组(P0.01);不稳定斑块组脂质池角度、巨噬细胞浸润、内膜侵蚀、斑块出现裂隙均多于稳定斑块组(P0.05);(2)不稳定斑块组患者MMP7、MMP9水平高于对照组和稳定斑块组(P0.05);(3)斑块纤维帽厚度与血清MMP9水平呈明显负相关(r=-0.336,P0.05);巨噬细胞浸润组MMP7、MMP9水平大于无巨噬细胞浸润组(P0.05);血管内膜有侵蚀组MMP9水平大于无内膜侵蚀组(P0.01)。结论OCT检测能够发现不稳定斑块,而血清MMP7、MMP9水平在不稳定斑块病变患者中明显升高,可作为预测不稳定斑块、指导治疗决策的重要依据。
[Abstract]:Objective to detect the characteristics of coronary atherosclerotic plaque and its relationship with the serum level of matrix metalloproteinase (MMP) 7 MMP9 and MMP12 by intracoronary optical coherence tomography (Oct). Methods from October 2014 to March 2016, patients with coronary artery disease were divided into stable plaque group and unstable plaque group according to Oct results. The thickness of fibrous cap, the angle of lipid pool, macrophage infiltration, plaque fissure and angiogenesis in plaque were detected by Oct. The basic data were collected and the serum MMP7 / MMP9 / MMP12 levels were detected by Elisa. Results (1) the thickness of fibrous cap in stable plaque group was greater than that in unstable plaque group (P 0.01), the angle of lipid pool, macrophage infiltration and intimal erosion in unstable plaque group. The level of MMP7 MMP9 in unstable plaque group was higher than that in control group and stable plaque group. There was a significant negative correlation between the thickness of fibrous cap of plaque and serum MMP9 level, and the level of MMP7 MMP9 in macrophage infiltration group was higher than that in macrophage infiltration group. The level of MMP9 in the group without macrophage infiltration was higher than that in the group without invasion of intima, and the level of MMP9 in the group with intimal invasion was higher than that in the group without invasion of intima. Conclusion Oct can detect unstable plaque, while serum MMP7 / MMP9 level is significantly increased in patients with unstable plaque, which can be used as an important basis for predicting unstable plaque and guiding treatment decision.
【作者单位】：昆明医科大学第一附属医院心脏内科;
【基金】：国家自然科学基金资助项目(81160025) 云南省科技厅应用基础研究(2015FB027);云南省科技厅科技惠民计划(2014RA011)
【分类号】：R541.4

【相似文献】