胱抑素C与冠状动脉斑块性质、病变特点的相关性  

Correlation between cystatin C and properties and features of coronary plague

作　　者：李华[1] 支莹 卢彦昭 耿松[1] 齐国先[1] 

机构地区：[1]中国医科大学附属第一医院心内科,沈阳110001

出　　处：《中华医学杂志》2015年第1期48-51,共4页National Medical Journal of China

摘　　要：目的 应用256层螺旋CT冠脉成像（CTA）,探讨胱抑素C与冠状动脉粥样硬化斑块性质和冠状动脉病变特点的相关性.方法 连续入选2013年1-10月因疑诊冠心病在中国医科大学附属第一医院心内科住院并行CTA检查结果为冠状动脉病变的患者.根据胱抑素C水平将其分为胱抑素C水平正常组（≤0.95 mg/L）和胱抑素C水平升高组（＞0.95 mg/L）;冠状动脉病变根据冠脉狭窄支数分为单支、双支和三支;根据冠脉狭窄程度分为轻度（＜50％）、中度（≥50％,＜75％）及重度（≥75％）;根据CT密度值将粥样硬化斑块分为非钙化斑块、混合斑块和钙化斑块,分析胱抑素C水平与冠状动脉受累范围、严重程度及斑块性质之间的关系.结果 纳入184例患者,胱抑素C水平正常组95例,胱抑素C水平升高组89例.共检出1 112处斑块,与胱抑素C水平正常组相比,胱抑素C水平升高组非钙化斑块所占比例较高（13.5％比8.8％,P＜0.01）,单支病变所占比例（22.5％比37.9％,P＜0.05）较低而三支病变所占比例（48.3％比33.7％,P＜0.05）较高.Logistic回归分析显示胱抑素C为多支病变的危险因素（OR=17.483,95％ CI：2.218～143.627;P＜0.01）.结论 冠脉病变患者中胱抑素C水平升高提示动脉硬化程度增加、斑块不稳定.Objective To explore the correlation between cystatin C （Cys C） and properties and features of coronary plague using 256-slice coronary computed tomography angiography （CTA）.Methods From January 2013 to October 2013,a total of 184 patients with suspected coronary artery disease undergoing CTA for coronary artery lesions were enrolled.Based on the results of cystatin C levels,they were divided into normal Cys C concentration group （≤0.95 mg/L） and high Cys C concentration group （＞0.95 mg/L）.Based on the results of CTA,they were divided into single-vessel,2-vessel and 3-vessel groups according to the number of diseased coronary arteries.And they were divided into mild stenosis （＜ 50％）,moderate stenosis （≥ 50％,＜ 75％） and severe stenosis （≥ 75％） groups according to the severity of coronary artery disease.The Hounsfield units were used to determine the soft,fibrous and calcified plaques for assessing the relationship between cystatin C levels and narrow severity score,pathological changes limits,plague properties.Results There were 95 with normal concentrations of Cys C and 89 with high concentrations of Cys C.A total of 1 112 plaques were detected and those with high concentrations of Cys C showed a higher proportion of non-calcified plaque （13.5％ vs 8.8％,P ＜ 0.01） compared with normal group.The proportion of those with 1-vessel disease was lower （22.5％ vs 37.9％,P ＜0.05） but 3-vessel disease higher （48.3％ vs 33.7％,P ＜0.05） than in normal group.Multiple Logistic regression analysis revealed that high Cys C was a significant risk factor for multi-vessel disease （OR =17.483,95％ CI：2.218-143.627 ; P ＜ 0.01）.Conclusion For patients with coronary artery lesions,a high level of Cys C may be associated with severity of coronary atherosclerosis and plaque instability.

关 键 词：256层螺旋CT 胱抑素C 斑块 冠状动脉病变 

分 类 号：R541.4[医药卫生—心血管疾病]