颈动脉内中膜厚度结合血清MMP-9及APN预测冠状动脉斑块稳定性

发布时间：2019-06-06 00:26

【摘要】：目的探讨颈动脉内-中膜厚度(CIMT)、血清脂联素(APN)、血清基质金属蛋白酶-9(MMP-9)诊断冠状动脉不稳定斑块的价值。方法选取接受OCT检查的急性冠状动脉综合征(ACS)患者27例(ACS组),并选取同期来诊的急性胸闷、胸痛而冠状动脉造影阴性者30例为对照组。检测血清APN及MMP-9,并行颈动脉超声检查,并记录CIMT、APN、MMP-9和冠状动脉斑块纤维帽厚度;分析两组指标的差异及各指标之间的相关性,绘制ROC曲线评价各指标对薄纤维帽斑块的诊断价值。结果 ACS患者CIMT、MMP-9水平显著高于正常组(P0.01),而APN水平显著低于正常组(P0.01);冠状动脉斑块纤维帽厚度与CIMT及MMP-9呈负相关(r=-0.357,P0.05;r=-0.477,P0.01),与APN呈正相关(r=0.468,P0.05);CIMT、MMP-9、APN联合检测诊断冠状动脉薄纤维帽斑块的ROC曲线下面积大于单个指标的曲线下面积(分别为:0.815、0.688、0.772、0.739)。结论 CIMT值及MMP-9水平升高、APN水平降低与冠状动脉斑块的稳定性密切相关,且三者联合对ACS更具诊断价值。
[Abstract]:Objective to evaluate the value of carotid intima-media thickness (CIMT), serum adiponectin (APN), serum matrix metalloprotease-9 (MMP-9) in the diagnosis of coronary artery unstable plaques. Methods 27 patients with acute coronary syndrome (ACS) group) underwent OCT examination (ACS group), and 30 patients with acute chest tightness, chest pain and negative coronary angiography were selected as control group. Serum APN and MMP-9, were detected by carotid ultrasound, and the thickness of CIMT,APN,MMP-9 and coronary artery plaque fiber cap was recorded. The difference between the two groups of indexes and the correlation between them were analyzed, and the ROC curve was drawn to evaluate the diagnostic value of each index in thin fiber cap plaques. Results the level of CIMT,MMP-9 in patients with ACS was significantly higher than that in normal group (P 0.01), while the level of APN was significantly lower than that in normal group (P 0.01). There was a negative correlation between the thickness of coronary artery plaque cap and CIMT and MMP-9 (r 鈮，

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