急性冠脉综合征患者冠状动脉重构与血脂水平的定量关系研究  

Quantitative Relationships between Coronary Vascular Remodeling and the Plasma Lipid Levels in Patients with Acute Coronary Syndrome

作　　者：许文亮[1] 宋达琳[1] 蔡湘丽[1] 任国瑞[1] 王海滨[1] 迟国安[1] 程凯[1] 康维强[1] 

机构地区：[1]青岛市市立医院心内科,山东省青岛市266011

出　　处：《实用心脑肺血管病杂志》2011年第10期1642-1644,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨急性冠状动脉综合征(ACS)患者靶病变血管重构方式与血脂的关系。方法 106例接受冠脉介入治疗的ACS患者,靶病变血管行血管内超声(IVUS)检查,测量靶病变段及其近端参考段血管外弹力膜面积(EEM),计算血管重构指数(RI):靶病变段EEM面积与近端参考段EEM面积之比。根据RI分为正性重构组(RI>1)69例和负性重构组(RI≤1)37例;根据年龄分为>60岁组(55例)和<60岁组(51例)。同期测定血清三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)水平。结果 RI与年龄显著负相关(r=-0.38,P=0.03),与血清TG水平显著正相关(r=0.32,P=0.02),血清TG水平正性重构组显著高于负性重构组(P=0.03);年龄<60岁组RI与血脂无相关关系,血脂水平正性重构亚组与负性重构亚组间无差异;年龄>60岁组,RI与血清LDL-C水平显著正相关(r=0.53,P=0.03),血清TG和HDL-C水平正性重构亚组显著高于负性重构亚组(P=0.01,P=0.04)。结论血脂水平影响ACS患者靶病变血管重构方式。Objective To investigate the relationships between target lesion artery remodeling and the plasma lipid levels in patients with acute coronary syndrome（ACS）.Methods Intravascular ultrasound（IVUS） analyses were performed in 106 ACS patients in the process of percutaneous coronary interventions.The remodeling index（RI） was calculated as the ratio between the external elastic membrane（EEM） at lesion site and the EEM at proximal reference.The patients were divided into the positive remodeling group（RI1） and negative remodeling group（RI≤1）（69 cases vs 37 cases）,and meanwhile,the old age group（older than 60 years） and non-old age group（equal or less than 60 years）（55 cases vs 51 cases）.At the same time the levels of plasma triglyceride,total cholesterol,LDL cholesterol and HDL cholesterol were determined.Results There is a significantly inverse relationship between RI and age（r=-0.38,P=0.03）,and a significantly direct relationship between RI and TG level（r=0.32,P=0.02）.The TG level in the positive remodeling group is marked higher than in the negative group（P=0.03）;In patients equal or less than 60 years a statistical correlations is not found between RI and lipid level,and there are no significant differences between positive remodeling subgroup and negative remodeling subgroup;In patients older than 60 years,RI is significantly related with LDL-C levels（r=0.53,P=0.03）,the levels of TG and HDL-C in positive remodeling subgroup are statistically higher than in negative remodeling group（P=0.01,P=0.04）.Conclusion The plasma lipid levels of the patients with ACS appear to have some effects on the target lesion artery remodeling.

关 键 词：急性冠脉综合征 冠脉重构 血脂 年龄 

分 类 号：R541.4[医药卫生—心血管疾病]