血管内超声比较急性冠状动脉综合征患者与稳定型心绞痛患者滋养血管的特点

目的探讨急性冠状动脉综合征(ACS)患者与稳定型心绞痛(SAP)患者病变血管中滋养血管的特点。方法选取2018年1-12月在湘潭市中心医院心内科住院行虚拟组织学-血管内超声(VHIVUS)分析的70例患者进行回顾性研究,其中30例为ACS患者,40例为SAP患者。比较两组患者的基线资料、斑块VH-IVUS特点及滋养血管特点。结果ACS组与SAP组滋养血管在最小管腔截面的出现率比较(96.7%比92.5%,P=0.852),差异无统计学意义;ACS组滋养血管在近端参考截面(90.0%比77.5%,P=0.018)、远端参考截面(90.0%比62.5%,P<0.001)的出现率均显著高于SAP组,差异均有统计学意义;ACS组患者最小管腔截面(2.9±1.2)条比(1.7±1.1)条,P<0.001]、近端参考截面(1.8±1.2)条比(1.2±1.0)条,P=0.003]及远端参考截面(1.6±1.1)条比(1.0±0.9)条,P=0.002]滋养血管的平均数量均显著高于SAP组,差异均有统计学意义。结论ACS患者斑块滋养血管的数量较SAP患者多,提示斑块内滋养血管的数量与其易损性相关。通过IVUS分析滋养血管特点是评估斑块易损性的另一种可行方法。

Using intravascular ultrasound analyze vasa vasorum between acute coronary syndrome and stable angina pectoris patients

Objective To evaluate the vasa vasorum(VV)characteristic between acute coronary syndrome(ACS)and stable angina pectoris(SAP)patients.Methods Between January 2018 and December 2018,there were 70 patients underwent VH-IVUS examination in Xiangtan central hospital.The baseline characteristics,VH-IVUS findings and VV in 30 ACS and 40 SAP patients were analyzed.Results The prevalence of VV at the minimum lumen area was similar between the 2 groups(96.7%vs.92.5%,P=0.852).On the other hand,it was signifi cantly higher in ACS than SAP at both reference sites(90.0%vs.77.5%,P=0.018 of proximal and 90.0%vs.62.5%of distal,P<0.001,respectively).The maximum number of VV was signifi cantly higher in ACS than in SAPat the minimum lumen area:(2.9±1.2)vs.(1.7±1.1),P<0.001,at the proximal reference:(1.8±1.2)vs.(1.2±1.0),P=0.003 and distal reference:(1.6±1.1)vs.(1.0±0.9),P=0.002,respectively].Conclusions VV of coronary arteries was more enhanced in patients with ACS than in those with SAP,supporting its relation to plaque vulnerability.VV detected by used IVUS could be an adequate surrogate marker for plaque vulnerability.