64排螺旋CT结合血清白细胞介素6（IL-6）检测对判定冠状动脉斑块稳定性价值的研究

目的本研究通过64排螺旋CT检测各型冠心病中软斑块、混合斑块（均为不稳定斑块／易破斑块）、钙化斑块（稳定斑块）的分布结合血清IL-6的检测，从临床的角度探讨其对冠脉斑块稳定性的判别价值。方法选用2007年4月至2008年8月本院89例住院接受冠脉造影的患者，进行64排螺旋CT冠脉造影检查和血清IL-6的检测。纳入本研究的患者根据临床诊断分为三组：正常对照组、稳定型心绞痛组（SAP、急性冠脉综合征组（ACS）（不包括急性ST段抬高的心肌梗死）。据64排螺旋CT检查根据斑块性质分为四组：（正常对照组、钙化斑块组、混合斑块组、软斑块组）。结果在ACS组软斑块、混合斑块的分布显著高于硬斑块，而在SAP组硬斑块的分布显著高于ACS组（P〈0．001）；各斑块组平均血清IL-6水平显著高于对照组（P〈0．01）；软斑块组、混合斑块组平均血清IL-6水平高于硬斑块组（P〈0．01）；而于软斑块组和混合斑块组两组内平均血清IL-6水平无显著差异（P〉0．05）。结论不稳定斑块组IL-6水平较稳定型斑块组明显升高，且有统计学意义。而各组之间年龄、性别及主要冠心病危险因素之间无明显差别。提示，64排螺旋CT结合IL-6检测，可对冠状动脉斑块的稳定性进行评估，对急性冠脉综合征危险分级提供有益参考。

Diagnostic value of combining 64-slice spiral computed tomography with serum interleukin-6 on coronary artery plaque stability

Objective To explore diagnostic value of combining 64-slice spiral computed tomography with serum interleukin-6 on coronary artery plaque stability. Methods 89 patients who took coronary angiography tests were enrolled form April 2007 to Auguest 2008 in this hospital. All patients underwent 64-slice spiral computed tomography. Blood samples were taken to measure levels of serum interleukin-6. Patients were divided into three groups： normol group, stable angina pectories group（SAP） and acute coronary syndrome group（ACS） （excepted ST-segment elevation myocardial infarction） according to the clinical diagnose. They were divided into four group（ normol group,soft plaque group,mix plaque group and hard plaque group） according to 64-slice spiral computed to, mography tests. Results Distribution of soft plaque and mix plaque was significantly higher than hard plaque in ACS group, and hard plaque in SAP group was significantly higher than that in ACS group （ P 〈 0. 001 ）. Mean levels of serum interleukin-6 in three plaque groups was obvious higher than that in normol group（）. Mean levels of serum interleukin-6 in soft plaque group and mix plaque group were higher than that in hard plaque group（ P 〈 0.01 ）. Mean levels of serum interleukin-6 in soft plaque group and mix plaque group have no obvious statistical difference（ P 〉 0.05）. Condtltsion Levels of serum interleukin-6 in unstable plaques were significantly higher than that in stable plaques. There were no difference in ages, sex and CHD risk factors among groups. This suggested that combining 64-CT angiography with serum level of IL-6 could contribute preferably to distinguishing plaque stability of coronary lesions in clinic, it is important for clinical diagnosis and risk evaluation of CHD patient.