血管内超声评估老年不稳定型心绞痛患者冠脉病变

目的 使用血管内超声探讨老年冠心病患者冠脉病变特点.方法 选择39例老年不稳定型心绞痛患者（UA）为研究对象, 28例稳定型心绞痛患者（SA）为对照组,使用血管内超声分别测定两组患者＂罪犯＂病变血管的外弹力膜面积（EEM）、管腔横截面积（LA）、斑块面积（PA）、斑块负荷（PB）、重构指数（RI）及偏心指数（EI）等指标,并利用虚拟组织学技术对斑块成分进行比较分析.结果 UA组和SA组患者的＂罪犯＂病变血管的LA、PA、PB比较差异均无统计学意义（P＞0.05）;两组EEM、RI、EI比较差异有统计学意义（P＜0.05）;UA组斑块中脂质、坏死组织所占比例较SA组显著增高,而SA组斑块以纤维组织多见（P＜0.01）.结论 老年冠心病患者临床表现与冠脉病变斑块结构、成分关系密切.

Evaluation of coronary artery disease in elderly patients with unstable angina by intravascular ultrasound

Objective To evaluate the characteristics of coronary artery disease in elderly patients by intravascular ultrasound （IVUS）. Methods Thirty- nine patients with unstable angina （UA）and twenty -eight patients with stable angina （SA） were enrolled in this study. The area of external elastic membrane （EEM） of vascellum, lumens area （LA） , plaque area （PA） ,plaque burden（PB） , eccentric index （EI）, remodeling index （RI）of coronary arteries were measured by IVUS in two groups. The plaque composition was analyzed by virtual histology technique. Results There was no significant difference in ＂criminal＂ lesions for LA , PA, PB between UA and SA group （ P 〉 0.05 ） , there was significant difference in EEM , EI and RI between two groups （ P 〈 0.05 ）. Compared with SA group, the proportion of lipid and necrotic tissue in plaques of UA group was higher, while the fibrous tissue was mostly found in plaques of SA group （ P 〈 0.01 ）. Conclusion There is close relationship between plaque morphology and clinical presentation in elderly patients with coronary artery disease.