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作 者:岑锦明[1] 梁茜[1] 熊卿圆[1] 杨希立[1] 许兆延[1] 梅百强[1] 蔡炜标[1] 柯媛媛[1]
机构地区:[1]广东省佛山市第一人民医院心血管内科,528000
出 处:《中华老年医学杂志》2013年第1期65-68,共4页Chinese Journal of Geriatrics
摘 要:目的探讨良性前列腺增生(BPH)患者冠状动脉(冠脉)粥样斑块病变特点及其临床意义。方法人选已接受冠状动脉造影术(CAG)患者91例(病变102处),其中BPH组50例,对照组41例,血管内超声(IVUS)对患者病变进行定性和定量分析,测量靶病变的外弹力膜横截面积(EEM—CSA)、最小管腔面积(MLA)、斑块面积(PA)、斑块负荷(PB)以及参考节段外弹力膜横截面积(REEM—CSA)、管腔横截面积(RMAL)、参考节段斑块面积(RPA)、参考斑块负荷(RPB)。结果IVUS与cAG比较,检出血管面积狭窄率高[(58.2±7.1)%比(55.9±5.2)%,P〈0.01]。BPH组冠脉内软斑块、偏心斑块和正性重构多见,而钙化少见;BPH组与对照组比较,MLA[(5.61±0.96)mm2比(6.06±0.75)mm2,P〈0.053和RMAL[(9.26±1.05)mm2比(10.02±1.10)mm2,P〈0.053减少;而EEM—CSA[(14.51±1.10)mm2比(13.37±1.02)mm2]、PA[(8.90±1.24)mm。比(7.31±1.04)mm2]、PB((61.26±6.53)%比(54.53±5.69)%]、RPA[(4.26士1.15)mm2比(3.73±1.33)mm2]、RPB((31.30±8.37)%比(26.81±8.75)%]增加(均P〈0.05)。结论IVUS对评价冠脉轻中度病变有较高价值;有心肌缺血证据的BPH患者需进一步排除冠心病。Objective To study the characteristics and clinical significance of the coronary plaques in patients with benign prostatic hyperplasia (BPH). Methods A total of 91 patients undergoing coronary artery angiography (CAG) were selected and divided into two groups according to with or without BPH, 56 cases in BPH group, 46 cases in control group. The qualitative and quantitative characteristics of 102 lesions area were analyzed by intravascular ultrosound (IVUS), including external elastic membrane-cross-sectional area (EEM-CSA), minimal lumen area (MLA), plaques area (PA), plaques burden (PB), reference external elastic membrane-cross-sectional area (REEM-CSA), reference minimal lumen area (RMAL), reference plaques area(RPA) and reference plaques burden (RPB). Results IVUS showed a higher rate of area stenosis than did the CAG [(58. 2± 7.1)% vs. (55.9±5.2)%,P〈0.01]. BPH group had more soft plaques, eccentric plaques, positive remodeling and less calcified than did the control group (P〈0.05). The MLA and RMAL of BPH group were smaller than those of control group.. MAL [(5. 61±0. 96) mm2 vs. (6.06 ±0.75) mm2, P〈0.05], RMAL[(9.26±1. 05) mm2vs. (10.02±1.10) mm2, P〈0.05]; while the EEM-CSA, PA, PB, RPA, RPB were larger than those of control group: EEM-CSA((14.51±1.10) mm2vs. (13.37±1.02) mm2], PA[(8.90±1.24) mm2vs. (7.31±1.04) mm2], PB[(61.26± 6.53)% vs. (54.53±5.69)%],RPA[(4.26±1.15) mm2vs. (3.73±1.33) mm2], RPB ((31.30± 8.37) %vs. (26.81±8.75) %, P〈0.05]. Conclusions IVUS has a higher value on evaluation of mild to moderate coronary artery stenosis. Evidence of myocardial ischemia in patients with BPH needs further excludeing coronary heart disease.
关 键 词:前列腺增生 冠状动脉疾病 动脉粥样硬化 超声 血管内
分 类 号:R541.4[医药卫生—心血管疾病]
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