杨丽霞,郑甲林,严睿,齐峰

• 1:成都军区昆明总医院心血管内科
• 2:成都军区昆明总医院医学影像科

摘要(Abstract)：

目的评价64层螺旋CT联合炎症因子高敏C反应蛋白(hs-CRP)及基质金属蛋白酶9(MMP-9)检测急性冠状动脉综合征(ACS)患者易损斑块的临床价值。方法入选72例冠心病患者,其中ACS组43例,稳定型心绞痛(SAP)组29例,进行64层螺旋CT冠状动脉成像,根据CT值将ACS组、SAP组犯罪血管处斑块分为软斑块、纤维斑块、钙化斑块。同时检测患者血清hs-CRP及血浆MMP-9浓度,并进行选择性冠状动脉造影检查,明确冠状动脉病变部位及性质。对照组25例。结果(1)ACS组软斑块发生率较SAP组明显高,差异有统计学意义(24/43比4/29,P=0.001);(2)与对照组比较,SAP、ACS组hs-CRP(4.12±2.82mg/L比6.11±2.60mg/L比11.26±3.03mg/L)、MMP-9(54.87±47.73ng/mL比91.69±55.72ng/mL比187.86±64.73ng/mL)浓度明显升高,差异有统计学意义(P均<0.05);且ACS组较SAP组升高更明显,差异有统计学意义(P<0.05);(3)冠心病的软斑块亚组与纤维斑块、钙化斑块亚组比较hs-CRP(12.69±2.41mg/L比7.47±2.52mg/L比6.39±2.87mg/L)、MMP-9(211.67±57.87ng/mL比121.48±55.86ng/mL比95.99±62.29ng/mL)浓度明显升高,差异有统计学意义(P均<0.05);(4)冠心病患者冠状动脉斑块CT值与hs-CRP、MMP-9浓度呈负相关。结论联合检测炎症因子hs-CRP及MMP-9,能够提高64层螺旋CT检测ACS患者冠状动脉斑块性质的准确性,并提示斑块稳定性,提高对ACS的诊断率。

关键词(KeyWords)： 冠状动脉疾病;体层摄影术,螺旋计算机;C反应蛋白质;基质金属蛋白酶类

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 杨丽霞,郑甲林,严睿,齐峰

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