刘巍,高雅楠,侯方杰,吴思婧,郭永和,刘晓丽,葛海龙,赵迎新,周玉杰

• 1:首都医科大学附属北京安贞医院心内科北京市心肺血管疾病研究所

摘要(Abstract)：

目的通过使用光学相干断层成像(optical coherence tomography,OCT)探究吸烟的年轻急性冠状动脉综合征(acute coronary syndrome,ACS)患者冠状动脉斑块特征。方法纳入北京安贞医院2014年6月至2017年6月因ACS入院行OCT且年龄≤45岁的60例患者,根据是否吸烟将患者分为吸烟组(33例)和非吸烟组(27例),通过冠状动脉造影及OCT对患者冠状动脉的狭窄程度及斑块特征进行分析,比较两组患者的斑块特征及斑块易损性。结果吸烟组罪犯病变斑块处纤维增生(48.5%比77.8%,P=0.032)及微通道(18.2%比44.4%,P=0.046)的发生率低于非吸烟组,差异均有统计学意义;斑块破裂发生率高于非吸烟组(24.2%比3.7%,P=0.033),差异有统计学意义。二元logistic多变量回归分析显示,吸烟是发生斑块破裂的独立预测因素(OR 8.320,95%CI 0.969～71.435,P=0.027),高血压病(OR 0.301,95%CI 0.097～0.934,P=0.034)和吸烟(OR 0.269,95%CI 0.086～0.837,P=0.020)则是纤维增生的独立预测因子。结论吸烟患者斑块处纤维增生较少,斑块易损性较高,更易发生斑块破裂。因此吸烟是导致年轻ACS患者发生不良心血管事件的主要危险因素之一。

关键词(KeyWords)： 吸烟;冠状动脉粥样硬化斑块;光学相干断层成像

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(8147049);; 国家重点研发计划“精准医学研究”重点专项(2017YFC0908800);; 北京市医院管理局“登峰”计划专项经费(DFL20150601);北京市医院管理局“使命”计划专项经费(SML20180601)

作者(Author): 刘巍,高雅楠,侯方杰,吴思婧,郭永和,刘晓丽,葛海龙,赵迎新,周玉杰

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