许康世,单守杰,刘志忠,张俊杰,金国珍

• 1:盐城市第一人民医院心内科
• 2:南京医科大学附属南京医院心内科

摘要(Abstract)：

目的应用彩色编码血管内超声(iMAP-IVUS)比较急性冠状动脉综合征(ACS)患者和稳定型心绞痛(SAP)患者罪犯病变与非罪犯病变斑块组织学特征。方法连续纳入2014年5月至2016年10月于南京市第一医院行经皮冠状动脉介入治疗(PCI)的冠心病患者152例。术前行IVUS检查,根据入院时临床症状特征分为ACS组(62例)和SAP组(90例),共检出213处罪犯病变(ACS组76处,SAP组137处)和164处非罪犯病变(ACS组68处,SAP组96处)。使用i MAP-IVUS系统计算具有最小管腔横截面积的节段纤维面积百分比(纤维面积/斑块面积)和脂质面积百分比(脂质面积/斑块面积)。结果 ACS组患者罪犯病变处重构指数[(1.05±0.21)比(0.97±0.13),P=0.008]和偏心指数[(0.64±0.09)比(0.59±0.07),P=0.007]显著高于非罪犯病变。i MAP-IVUS分析显示:和SAP组患者相比,ACS组患者罪犯病变和非罪犯病变纤维面积百分比显著增加[(37±19)%比(30±16)%,P=0.003]和[(37±20)%比(31±17)%,P=0.027],而脂质面积百分比显著减少[(60±14)%比(63±13)%,P=0.032]和[(57±17)%比(63±15)%,P=0.031]。logistic多因素回归分析显示,ACS患者罪犯病变(OR 4.98,95%CI 1.54～17.90,P=0.006),非罪犯病变(OR 7.36,95CI 1.95～28.70,P=0.004)是预测富含脂质斑块独立预测因子。结论 ACS患者冠状动脉非罪犯病变与富含脂质斑块显著相关,提示此类患者广泛存在斑块易损性。

关键词(KeyWords)： 急性冠状动脉综合征;斑块;彩色编码血管内超声

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 许康世,单守杰,刘志忠,张俊杰,金国珍

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