急性冠状动脉综合征患者血清超敏C反应蛋白及抵抗素浓度与罪犯病变虚拟组织学-血管内超声特点的相关性

目的 通过分析急性冠状动脉综合征（ACS）患者血清超敏C反应蛋白及抵抗素浓度与罪犯病变虚拟组织学-血管内超声（VH-IVUS）特点相关性,研究血清超敏C反应蛋白及抵抗素影响斑块易损性的机制.方法 选取ACS患者60例,运用酶联免疫分析法（ELISA法）检测血清抵抗素浓度及血清超敏C反应蛋白浓度.结合心电图检查ST-T发生改变的导联,超声心动图出现室壁运动异常的节段以及冠状动脉造影发现复杂病变的部位确定罪犯病变.从而研究ACS患者血清抵抗素及超敏C反应蛋白浓度与ACS罪犯病变VH-IVUS特点的相关性.结果 超敏C反应蛋白浓度的中位数为3.66 mg/L,四分位数间距为2.21 mg/L.抵抗素浓度的中位数为3.53 mg/L,四分位数间距为6.28 mg/L.ACS患者血清抵抗素浓度与罪犯病变坏死核心体积绝对值呈正相关（r=0.427,P=0.01）;ACS患者血清超敏C反应蛋白浓度与罪犯病变坏死核心体积绝对值也呈正相关（r=0.322,P=0.01）.结论 ACS患者血清超敏C反应蛋白及抵抗素浓度的增加都伴随着罪犯病变脂质池的扩大.血清抵抗素浓度在评价斑块易损性方面可能较血清超敏C反应蛋白浓度更加敏感.

Relationship between plasma resistin and high-sensitivity C reactive protein and the virtual histology intravascular ultrasound characters of culprit lesions in ACS patients

Objective We analyse the relationship between plasma resistin and high-sensitive C reactive protein （hs-CRP） and the virtual histology intravascular ultrasound （VH-IVUS） characters of culprit lesions in acute coronary syndrome （ACS） patients, in order to know how plasma resistin and hs-CRP affect the plaque vulnerability. Method 60 ACS patients were included in our study. We used ELISA to analyse plasma resistin and hs-CRP. Culprit lesion was identified by analyzing ST-T alternation on electrocardiograms, left ventricular wall motion abnormalities, and angiographic complex lesions. We performed VH-IVUS examination on each culprit lesion and analyzed the relationship between plasma resistin, hs-CRP and the VH-IVUS characters of the culprit leision. Result Plasma resistin （median： 3.53 mg/L; interquartile range： 6.28 mg/L） was positively associated with the absolute volume of necrotic core （r=0.427, P=0.01 ） and it was statistically significant. Plasma hs-CRP （median： 3.66 mg/L; interquartile range： 2.21 mg/L） was positively associated with the absolute volume of necrotic core （r=0.322, P=0.01 ） and it was statistically significant either. Coneusion The increase of plasma resistin was related to the increase of vulnerability of culprit leision in ACS patients. Plasma resistin might be more sensitive than plasma hr-CRP when evaluated the plaque vulnerability.