冠状动脉粥样硬化性心脏病血管重构与斑块组成的血管内超声研究  

Intravascular ultrasound study of coronary artery remodeling and plaque composition in patients with coronary atherosclerotic heart disease

作　　者：任国瑞[1] 滕金龙[2] 康维强[1] 张华[1] 王海滨[1] 宋玉波[1] 荣瑗瑗[1] 胡小燕[1] 

机构地区：[1]青岛市市立医院老年内科,266011 [2]青岛大学附属医院重症医学科

出　　处：《中华超声影像学杂志》2015年第2期105-108,共4页Chinese Journal of Ultrasonography

摘　　要：目的 应用血管内超声技术检测同一冠状动脉粥样硬化性心脏病患者的血管内不同斑块组成与冠状动脉重构之间的关系.方法 24例患者的48处斑块纳入研究,对斑块应用血管内超声进行定性和定量测定,根据斑块组成回声的不同,分为软斑块、纤维斑块、钙化斑块和混合斑块四类.重构指数=病变处血管横截面积/平均参考血管面积.结果 同一患者的血管内,软斑块组重构指数明显大于硬斑块组（1.08±0.15比1.00±0.13,P=0.000）.软斑块组正性重构的斑块明显多于硬斑块组（83.3％比58.3％,P=0.057）,但P值略大于0.05,斑块面积、管腔面积、斑块负荷在软斑块组和硬斑块组之间差异无统计学意义（P＞0.05）.结论 软斑块处血管代偿性扩张,重构指数明显大于硬斑块处,以正性重构多见,正性重构是冠状动脉粥样硬化血管炎症急性期的血管内超声表现.Objective To demonstrate the relationship between plaque composition and coronary artery remodeling in the same patient＆#39;s blood vessel.Methods A total of 48 coronary artery plaque were included in this study.Qualitative assessment and quantitative measurements of the lesion were performed in target lesions.The lesions were classified into soft plaque,fibrous plaque,calcified plaque and mixed plaque according to different degree of reflection of ultrasound signal.The remodeling index （RI） was defined as the ratio of external elastic membrane cross sectional area of lesion segment to the mean reference external elastic membrane cross sectional area.Results In comparison to hard plaque group,RI of soft plaque group was significantly larger in the same patient （1.08± 0.15 vs 1.00 ± 0.13,P =0.000）.Soft plaque group presented with more positive remodeling than hard plaque group,but with P value more than 0.05 （83.3 %vs 58.3%,P =0.057）.The plaque area,lumen area and plaque burden were not different between two group （P 〉0.05）.Conclusions The blood vessel was compensatively dilated in soft plaque segments and RI was significantly larger than in hard plaque segments.Coronary atherosclerotic vessel presented positive remodeling in the acute stage of inflammation.

关 键 词：腔内超声检查 冠状动脉疾病 血管重构 斑块 动脉粥样硬化 

分 类 号：R541.4[医药卫生—心血管疾病]