不稳定型心绞痛患者血管内超声影像学特征与sCD40L水平的关系

目的 目的探讨稳定型心绞痛(SA)和不稳定型心绞痛(UA)患者的冠状动脉斑块在血管内超声(IVUS)下的表现特征;可溶性CD40L(sCD 40L)血清水平在SA、UA患者中的变化特点以及它们之间的相互关系.方法 21倒SA、30例UA患者行冠脉造影,"犯罪"血管同时行血管内超声(IVUS)检查;另取冠状动脉造影正常的患者20例为对照组(NS);所有的患者均检测sCD40L血清水平.结果 SA组以稳定型纤维性斑块为主,UA组以不稳定型脂质斑块为主.SA组主要表现为负性重构或无重构,而UA组主要表现为正性重构.UA组的脂质斑块教、不稳定型宽块数、偏心指数(EI)、重构指数(RD)显著高于SA组.UA组的sCD40L血清水平显著高于SA组和NS组,SA组的sCD40L血清水平高于NS组.结论 SA患者和UA患者冠状动脉斑块的成分和结构特点存在显著差异,sCD40L血清水平有可能成为预测冠心痛不稳定斑块的参考指标之一.

Relationship between Intravascular Ultrasound Features of Conronary Artery Plaques and Serum Level of sCD40L in Patients with Unstable Angina

Objective To investigate the morphological features of atherosclerotic plaques by intravascular ultrasound (IVUS) and the difference of soluble CD40L (sCD40L) levels in stable angina (SA) and unstable angina (UA) and to explore the relationship between them. Methods Coronary angiography (CAG) and IVUS was performed on 21 patients with SA and 30 patients with UA. 20 cases with negative results in CAG were selected as the control group (NS). Concentrations of sCD40L were measured with Enzyme-Linked-Immunosorbent Assay (ELISA) in all cases. Results The patients in SA group were mainly having stable and fibrous plaques, while the patients in UA group were mainly having unstable and soft lipid plaques. Calcific plaques in the two groups had no statistical differences. Eccentric index (EI), remodeling index (RI) and the numbers of soft plaques and unstable plaques in UA group were significantly higher than those in SA group. The serum levels of sCD40L were significantly higher in UA group than those in SA group and in NS group, the serum levels of sCD40L were also significantly higher in SA group than those in NS group. Conclusion The morphological features of coronary artery plaques in UA group were significantly different from those in SA group. The serum levels of sCD40L may be the index of the vulnerability of the coronary plaques.