老年稳定型心绞痛冠状动脉临界病变斑块特征及其与血脂的相关性研究  

Characteristics of intermediate coronary lesion and the correlation with blood lipid in elderly patients with choronic stable angina pectoris

作　　者：何华[1] 韩福生[1] 李勇[1] 田雪[1] 王喜福[1] 曾玉杰[1] 

机构地区：[1]首都医科大学附属北京安贞医院急诊重症监护室心脏病房,100029

出　　处：《中国医药》2015年第7期952-954,共3页China Medicine

基　　金：国家自然科学基金（81100142）;教育部心血管重塑相关疾病重点实验室开放性课题基金（2010XGCS02）;北京市卫生系统高层次人才培养计划（2014-34）42）;首都医科大学附属北京安贞医院院长基金（2010F03）

摘　　要：目的 探讨老年稳定型心绞痛冠状动脉临界病变斑块特征及其与血脂的相关性.方法 入选2013年1月至2014年10月在首都医科大学附属北京安贞医院行冠状动脉造影并诊断为冠状动脉临界病变的老年稳定型心绞痛患者97例,行血管内超声检查,分析患者斑块负荷、斑块成分等斑块特征,同时抽血检测血脂各成分水平,并对冠状动脉临界病变斑块特征与血脂的相关性进行分析.结果 男女性患者分别为40例和57例;斑块负荷分别为（62.2±8.6）％和（67.3±10.1）％;无论男性还是女性患者,其临界病变累及血管均以左前降支为主（65.0％、68.4％）,其次为右冠状动脉（20.0％、24.6％）,累及左回旋支者最少（12.5％、7.0％）;斑块成分均以纤维成分为主[（55.2±13.1）％、（58.3±10.4）％],其次为纤维脂质成分[（21.2±13.8）％、（24.6±12.5）％],再次为坏死成分[（16.9±8.9）％、（15.4±7.3）％],钙化成分最少[（5.6±4.2）％、（4.9±3.7）％].Pearson相关性分析结果表明冠状动脉临界病变斑块的不同特征与各血脂水平间无明显相关性.结论 老年稳定型心绞痛患者冠状动脉临界病变斑块以纤维成分最多,钙化成分最少,其特征与血脂无相关性.Objective To determine the characteristics of intermediate coronary lesion and the correlation with blood lipid in elderly patients with stable angina.Methods Ninety seven elderly patients with chronic stable angina and intermediate coronary lesion from January 2013 to October 2014 were enrolled.The intravascular ultrasound to obtain the characteristics of intermediate coronary lesions,including lesion burden and lesion components.In addition,the level of serum lipid was determined and the correlation between the characteristics of the intermediate coronary lesion and serum lipid was analyzed.Results There were 40 male patients and 57 female patients,and the lesion burden was （62.2 ± 8.6） % and （67.3 ± 10.1） %,respectively.The left anterior descending branch was the most common coronary artery involved in males （65.0%） and females （68.4%）,followed by the right coronary artery （males：20.0%,females：24.6%） and left circumflex branch （males：12.5%,females：7.0%）.The fibrotic component was the most in the lesions [males：（55.2 ± 13.1）%,females：（58.3 ± 10.4） %],followed by fibrofatty component [males：（21.2 ± 13.8） %,females：（24.6 ± 12.5） %] and necrosis component[males：（16.9 ± 8.9）%,females：（15.4 ± 7.3）%];the calcified component was the least [males：（5.6 ± 4.2） %,females：（4.9 ± 3.7） %].The Pearson analysis indicated that the characteristics of the intermediate coronary lesions was not related to the level of serum lipid.Conclusions Fibrotic component is the predominant component of intermediate coronary lesion in elderly patients with chronic stable angina,and the calcified component was the least.The component characteristics of the lesions are not correlated with serum lipid.

关 键 词：冠状动脉疾病 临界病变斑块 血脂 

分 类 号：R541.4[医药卫生—心血管疾病]