不同冠状动脉病变患者血管内超声影像学特征与血清可溶性CD105水平的关系

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)斑块在血管超声(IVUS)下的特征及血清可溶性CD105水平在SA及UA患者中的变化特点.方法 127例拟诊冠心病患者,均行冠状动脉造影(CAG)检查,CAG结果阴性者纳为对照组30例;SA组50例;UA组47例.均测定血清CDl05水平.抽取其中31例SA患者、31例UA患者行冠脉IVUS检查.结果 IVUS显示SA组病变处主要为稳定型、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显著性(SA组12.0%,UA组18.0%,P＜0.05).UA组的偏心指数(EI)显著高于SA组(uA组0.82±0.55,sA组0.54±0.23,P＜0.05),有以正重构为主的趋势.血清可溶性CD105水平UA组显著高于SA组(4.06±0.19)μg/L,(3.47±0.17)μg/L和对照组(2.57±0.54μg/L,P＜0.01);不稳定型斑块组(4.01±0.18)μg/L显著高于稳定型斑块组(3.22±0.16)μg/L,(P＜0.01).结论 SA患者及UA患者的冠脉斑块在性质及结构特点不同.可溶性CD105参予动脉硬化的形成,是冠心病发生发展的标记物.

Relationship between intravascular ultrasound imaging features and soluble serum CD105 level in patients with different coronary lesions

Objective To assess the relationship between the level of serum soluble CD105 and the morphology of plaques examined by intravaseular ultrasound (IVUS) in the patients with stable angina (SA) and unstable angina (UA). Methods 127 patients suspected as having coronary heart disease (CHD) underwent coronary artery angiography (CAG) and then divided into 3 groups according to the CAG results:stable angina (SA) group (n =50), unstable angina (UA) group (n =47), and control group (n =30).Peripheral blood samples were collected and serum soluble CD105 was measured by ELISA. 31 patients from the SA group and 31patients from the UA group underwent IVUS. Results The patients of the SA group mainly had fibrous plaques, while the patients of the UA group mainly had unstable and soft lipid plaques.Calcific plaques were found in the SA group ( 12% ) as well as in the UA group with no statistical difference (18.0%, P=0.08). The eccentric index (EI) of the UA group was 0.82±0.55, significantly higher than that of the SA group (0.54±0.23, P＜0.05 ). The serum soluble CD105 level of the UA group was (4.06±0.19 ) μg/L, significantly higher than that of the control group and SA group [ ( 2.57±0. 54)μg/L and (3.47±0.17) μg/L respectively, both P＜0.05 ], and serum soluble CD105 level of the SA group was significantly higher than that of the control group too ( P＜0.05). The concentration of soluble CD105 in vulnerable plaque group was (4.01±0.18 )μg/L, significantly higher than that of the stable plaque group [ (3.22±0.16 ) μg/L, P＜0.01 ]. Conclusion The serum soluble CD105 level of the UA group is significantly higher than those of the patients with SA and those without CHD. The level of soluble CD105may reflect the instability of CHD as well as the vulnerability of plaques.