不同冠状动脉病变患者血管内超声影像学特征与血浆高敏C反应蛋白水平的关系Relationship between intravascular ultrasound imaging features and hs-CRP level in the patients with different coronary lesions
崔松,吴惠玲,何国祥,刘建平,冉擘力,李永华,涂爱华,文玲
摘要(Abstract)：
目的探讨稳定型心绞痛(SA)及不稳定型心绞痛(UA)患者冠状动脉(冠脉)斑块在血管内超声(IVUS)下的表现特征及血浆高敏C反应蛋白(hs-CRP)水平在SA及UA患者中的变化特点。方法102例拟诊冠心病的患者:冠脉造影(CAG)结果阴性者纳为对照组,30例;SA组,25例;UA组,47例。所有研究对象均行CAG检查,均测定血浆hs-CRP水平。对其中的9例SA患者、31例UA患者行血管内超声(IVUS)检查。结果SA组主要为稳定型、纤维性斑块,UA组主要为不稳定型、脂质性斑块。钙化性斑块在两组中的分布差异无统计学意义。UA组的偏心指数(EI)显著高于SA组,有以正重构为主的趋势。血浆hs-CRP水平UA组显著高于SA组,非常显著地高于对照组;SA组与对照组类似。不稳定型斑块组血浆hs-CRP水平非常显著地高于稳定型斑块组。结论SA患者及UA患者的冠脉斑块在性质及结构特点上差异有统计学意义。hs-CRP水平有望成为预测冠脉斑块易损性的参考指标之一。
关键词(KeyWords)： 冠状动脉疾病;超声检查,介入性;C反应蛋白质
基金项目(Foundation):
作者(Author): 崔松,吴惠玲,何国祥,刘建平,冉擘力,李永华,涂爱华,文玲
参考文献(References)：
- [1]Ge J,Chirillo F,Schwedtmann J,et al.Screening of rupturedplaques in patients with coronary artery disease by intravascularultrasound.Heart,1999,81:621-627.
- [2]Fussl RT,Kranenberg E,Kiausch U,et al.Vascular remodeling inatherosclerotic coronary arteries is affected by plaque composition.Coron Artery Dis,2001,12:91-97.
- [3]Libby P.Changing concepts of atherogenesis.J Intern Med,2000,247:349.
- [4]Hassan A,Basisht R,Nakamura M,et al.Morphologicalcharacteristics of de novo coronary lesions presenting with plaquerupture:an intravascular ultrasound study.J Am Coll Cardiol,2004,43:A73.
- [5]Nomoto K,Oguchi S,Watanabe I,et al.Involvement of inflammationin acute coronary syndromes assessed by levels of high-sensitivity C-reactive protein,matrix metalloproteinase-9 and soluble vascular-celladhesion molecule-1.J Cardiol,2003,42:201-206.
- [6]Hong MK,Lee CW,Kim YH,et al.Independent predictors ofmultiple vulnerable plaque in 143 patients with acute coronarysyndrome:a prospective study of three-vssel intravascular ultrasound.J Am Coll Cardiol,2004,43:A73.