轻中度狭窄病变血管内超声影像学特征与超敏C反应蛋白的关系研究

目的 探讨冠状动脉轻中度狭窄病变斑块超声影像学特征与血清超敏C反应蛋白的关系.方法 78例冠心病患者分为轻中度狭窄组(62例)和重度狭窄组(16例),对两组患者靶血管内超声特征与血清超敏C反应蛋白进行相关研究.结果 轻中度狭窄组血管内超声检出脂质斑块51例82.26%(51/62),其病变的血管外弹力膜面积(EEMA)、斑块面积(PA)及管腔面积狭窄率(LAS)、重构指数(RI)明显大于重度狭窄组,差异有显著性意义(均P＜0.05).两组间在纤维帽厚度、脂核或无回声带大小、脂核与斑块比存在统计学差异.血清超敏C反应蛋白与EEMA、RI呈正相关.结论 易损斑块为偏心分布的低回声脂质斑块,具有较大的斑块面积和明显的正性重构;血清超敏C反应蛋白可望作为冠脉斑块易损性预测的参考指标.

Correlation between intravascular ultrasound features of atherosclerotic plaques and high-sensitivity C-reactive protein

Objective To assess the relationship between intravascular ultrasound (IVUS) features of mild lesion identified by angiography and high-sensitivity C-reactive protein (hs-CRP) in patients with angina pectoris. Methods Seventy-eight patients with angina pectoris were divided into mild lesion group (n=68) and severe stenosis group (n=16) after angiography. hs-CRP was measured and compared between two groups, and IVUS was used to analyze their coronary lesions. The correlation analysis was used to analyze the relation between intravascular ultrasound (IVUS) features and hs-CRP. Results IVUS found that 82.26% (51/62) patients in mild lesion group had soft lipid plaques. External elastic membrane area (EEMA), plaque area (PA), area stenosis ratio (LAS) and remodeling index (RI) in mild lesion group were larger than those in severe stenosis group (all P<0.05). There was significant difference in the thickness of fibrous cap, the lipid core areas and lipid to plaque ratio between mild lesion group and severe stenosis group. hs-CRP in plasma was of positive correlation with EEMA and RI. Conclusion Vulnerable atherosclerotic plaques are eccentric, soft lipid plaques, with large plaque areas and the vessel of positive remodeling at the lesion. hs-CRP could be used as reference indices for the identification of plaque vulnerability.