冠状动脉粥样硬化斑块破裂的临床危险因素分析

目的　研究临床危险因素与冠状动脉粥样硬化斑块破裂的关系 ,探讨斑块破裂的危险因素。方法　选取 1992～ 1998年间的尸检病例 ,急性心肌梗死 (AMI) 2 0例 ,不稳定心绞痛 (UA) 10例 ,稳定心绞痛 (SA) 12例 ,对所有冠状动脉连续取材制片 ,常规及免疫组化染色 ,光镜观察斑块破裂的形态改变及血栓伴随情况 ,并调查 8个相应的临床危险因素。结果　 8个危险因素中 ,血浆甘油三酯水平与斑块破裂有关 (P <0 .0 5 )。结论　高血浆甘油三酯是国人急性冠状动脉综合征患者斑块破裂的一个重要危险因素。

Analysis of clinical risk factors in autoptic patients with coronary atherosclerotic plaque rupture

Objective Rupture of coronary atherosclerotic plaque plays an important role in arterial thrombosis which has been considered the cause of acute coronary syndrome,including unstable angina (UA),acute myocardial infarction (AMI),and sudden cardiac death (SCD).The aim of this study was to investigate the relationship between plaque rupture and clinical risk factors.Methods 42 autoptic patients died in recent 6 and half years were selected.Of them 20 cases died of acute myocardial infarction,10 cases had history of unstable angina and 12 died of non cardiovascular diseases with history of stable angina.The coronary arteries of each case was transversely cut at 5 mm interval,embedded in paraffin and stained with H&E and immunohistochemical techniques.The morphological features of various plaques were correlated with 8 clinical risk factors.Results Of the eight risk factors,only serum triglyceride level and plaque rupture correlated well with statistic significance(P< 0.05). Conclusions High serum triglyceride level is an important risk factor for plaque rupture in patients with acute coronary syndrome in China.