急性冠脉综合征患者致病斑块破裂与其临床特征的关系  

Association of culprit plaque rupture and clinical characteristics in patients with acute coronary syndrome

作　　者：周华[1] 何晓燕[1] 庄少伟[1] 王娟[1] 来晏[1] 姚义安[1] 刘学波[1] 汪程 

机构地区：[1]上海市东方医院心脏病科,200120 [2]新疆维吾尔自治区莎车县人民医院心脏病科

出　　处：《江苏医药》2013年第9期1067-1069,共3页Jiangsu Medical Journal

摘　　要：目的分析急性冠脉综合征(ACS)患者的临床特征,探讨致病斑块破裂与ACS患者临床特征的关系。方法 69例ACS患者行血管内超声检查后分为有斑块破裂(A组,38例)和无斑块破裂(B组,31例)两组,分析致病斑块破裂与ACS患者临床特征的关系。结果与B组比较,A组患者年轻、男性多见、代谢综合征的发病率高(P<0.05)、血清高密度脂蛋白(HDL)低(P<0.01)、病变血管重构指数大(P<0.01)。多变量分析显示,代谢综合征是预测斑块破裂的独立危险因素(OR=5.26,95%CI=1.49-21.40,P<0.05)。结论低血清HDL为特征的代谢综合征在伴有冠脉代偿性扩张的不稳定斑块破裂中可能起着关键作用。Objective To investigate the association of culprit plaque rupture and clinical characteristics in patients with acute coronary syndrome （ACS）. Methods Intravascular ultrasound （IVUS） examination was performed in 69 patients with ACS, who were assigned into two groups of A （38 cases with culprit plaque rupture） and B（31 cases without plaque rupture）. The relationship of culprit plaque rupture and clinical characteristics of ACS was analyzed. Results Compared to group B, the patients in group A were younger and more male with higher incidence of metabolic syndrome （P〈0, 05）, lower level of serum high-density lipoprotein（HDL）（P〈0. 01）, and higher remodeling index of diseased vessels（P〈0. 01）. Multivariate analysis showed that metabolic syndrome was an independent predictor for culprit plaque rupture （OR=5.26, 95% CI = 1.49-21.40, P〈0. 05 ）. Conclusion Metabolic syndrome characterized by low HDL may serve as the key factor for vulnerable plaque rupture in ACS patients with coronary compensatory enlargement.

关 键 词：急性冠脉综合征 血管内超声 斑块破裂 血管重构指数 

分 类 号：R543[医药卫生—心血管疾病]