论文部分内容阅读
目的:总结影响冠脉斑块稳定性的因素,并对入选对象作为期1年的随访研究。方法:回顾性分析2007年4月至2011年4月就诊于我院,经冠脉造影术确诊为冠心病,并行血管内超声(IVUS)检查的104例患者的临床资料。依据IVUS结果分为不稳定性斑块组(A组)和稳定性斑块组(B组),比较两组间的差异。结果:两组患者一般临床特征无明显统计学差异。冠脉介入术前,A组血清脂蛋白(a)[Lp(a)]明显高于B组[(292.6±139.5)mmol.L-1比(216.9±66.4)mmol.L-1,P=0.001];A组纤维蛋白原明显高于B组[(3.4±0.6)g.L-1比(2.6±0.3)g.L-1,P<0.001];A组超敏C反应蛋白(hs-CRP)明显高于B组[(7.8±6.5)mg.L-1比(1.9±0.9)mg.L-1,P<0.001]。A组中正性重构的比例高于B组(78.8%比5.8%,P<0.001);A组软斑块比例高于B组(38.5%比9.6%,P=0.001)。hs-CRP、Lp(a)及纤维蛋白原与纤维帽厚度呈负相关。平均1年随访期间,A组累积的主要心血管事件有高于B组的趋势(log rankχ2=0.371,P=0.034)。结论:不稳定斑块患者hs-CRP、Lp(a)、及纤维蛋白原明显升高,正性重构、偏心病变较多,且狭窄程度、斑块负荷较重,1年主要心血管事件有高于稳定斑块患者的趋势。
OBJECTIVE: To summarize the factors affecting the stability of coronary artery plaque and to investigate the selected subjects for a one-year follow-up. Methods: The clinical data of 104 patients diagnosed as coronary heart disease by coronary angiography and performed intravascular ultrasound (IVUS) examination from April 2007 to April 2011 were analyzed retrospectively. According to IVUS results were divided into unstable plaque group (A group) and stable plaque group (B group), the difference between the two groups was compared. Results: The two groups of patients with general clinical features no significant difference. Before PCI, serum lipoprotein (a) [Lp (a)] in group A was significantly higher than that in group B [(292.6 ± 139.5) mmol.L-1 vs (216.9 ± 66.4) mmol.L-1, P = 0.001]. The fibrinogen in group A was significantly higher than that in group B [(3.4 ± 0.6) gL-1 vs (2.6 ± 0.3) gL-1, P <0.001] (7.8 ± 6.5) mg.L-1 (1.9 ± 0.9) mg.L-1, P <0.001]. The proportion of positive remodeling in group A was higher than that in group B (78.8% vs 5.8%, P <0.001). The proportion of soft plaque in group A was higher than that in group B (38.5% vs 9.6%, P = 0.001). hs-CRP, Lp (a) and fibrinogen were negatively correlated with the thickness of fibrous cap. During an average 1-year follow-up, major cardiovascular events accumulated in group A were higher than those in group B (log rank 2 = 0.371, P = 0.034). CONCLUSIONS: The hs-CRP, Lp (a) and fibrinogen in patients with unstable plaques were significantly higher than those in controls. The positive remodeling, eccentric lesions were more and the degree of stenosis and plaque burden were heavier. One-year major cardiovascular events There is a trend higher than stable plaque patients.