64层螺旋CT结合高敏C-反应蛋白、D-二聚体水平对判定冠状动脉斑块稳定性价值的研究  

Diagnostic Value of Combining 64-slice Spiral Computed Tomography with Serum High Sensitive C-reactive Protein and D-dimer on Coronary Artery Plaque Stability

作　　者：曹东平[1] 彭应心[1] 姚文静[1] 高楠[1] 乔淑章[1] 容春莉[1] 于薇[1] 

机构地区：[1]河北省人民医院心脏中心,石家庄050051

出　　处：《中国医药导刊》2009年第10期1688-1690,共3页Chinese Journal of Medicinal Guide

摘　　要：目的探讨64层螺旋CT检测冠脉斑块特征结合血清高敏C反应蛋白(hsCRP)及血浆D-二聚体水平的检测,从临床的角度探讨其对冠脉斑块稳定性的判别价值。方法:对本院80例住院接受冠脉造影的患者,进行64层螺旋CT检查和血清hsCRP及血浆D-二聚体水平的检测。根据临床诊断分为三组:稳定型心绞痛组(SAP)、急性冠脉综合征组(ACS)、正常对照组;据64层螺旋CT检查根据斑块性质分为四组:软斑块组、混合斑块组、硬斑块组、正常对照组。结果: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组软斑块组、混含斑块组(P<0.01)。各斑块组hsCRP及D-二聚体水平显著高于对照组(P<0.01);软斑块、混合斑块组hsCRP及D-二聚体水平高于硬斑块组(P<0.01);而于软斑块组和混合斑块组两组内hsCRP及D-二聚体水平无显著差异(P>0.05)。结论:64层螺旋CT冠状动脉斑块检查结合血清hsCRP,血浆D-二聚体水平检测可作为冠状动脉斑块不稳定性的预测指标。Objective：To explore diagnostic value of combining 64-slice spiral computed tomography with serum high sensitive C-reactive protein and D-dimer on coronary artery plaque stability. Methods：80 patients who took coronary angiography tests were enrolled in this hospital. All patients underwent 64-slice spiral computed tomography. Blood samples were taken to measure levels of serum high sensitive C-reactive protein and D-direct. Patients were divided into three groups：normol group, stable angina pectories group（SAP） and acute coronary syndrome group（ACS） 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 groupwas significantly higher than that in ACS group （P〈0.01）. Mean levels of serum high sensitive C-reactive protein and D-dimer in three plaque groups was obvious higher than that in norol group（P〈0.01）.Mean levels of serun, high sensitive C-reactive protein and D-direct in soft plaque group and mix plaque group were higher than that in hard plaque group（P〈0.01）. Mean levels of serum high sensitive C-reactive protein and D-dimer in soft plaque group and mix plaque group have no obvious statistical difference （P〉0.05）. Conclusion： This suggested that combining 64-CT angiography with serum level of high sensitive C-reactive protein and D-dirtier contribute preferably to distinguishing plaque stability of coronary lesions in clinic,it is important for clinical diagnosis and risk evaluation of CHD patient.

关 键 词：体层摄影术 X线计算机 动脉粥样硬化斑块 高敏C反应蛋白 血浆D-二聚体 

分 类 号：R816.2[医药卫生—放射医学]