多层螺旋CT联合同型半胱氨酸诊断冠状动脉斑块稳定性的临床应用价值  

Clinical value of multislice spiral computed tomography combined with Homocysteine( Hcy) for detecting the stability of coronary artery plaques

作　　者：解晓江[1] 肖学慧[1] 刘艳阳[1] 

机构地区：[1]内蒙古医科大学附属医院心内科,呼和浩特市010059

出　　处：《临床合理用药杂志》2015年第32期1-2,共2页Chinese Journal of Clinical Rational Drug Use

基　　金：内蒙古医科大学附属医院科研立项(No:NYFY YB2014023);内蒙古自治区高等学校科学研究项目(No:NJZZ097)

摘　　要：目的通过对冠心病患者行64排螺旋CT检查和同型半胱氨酸(Hcy)水平检测,探讨其对冠状动脉斑块稳定性的预测价值。方法选择拟诊为冠心病的患者83例为研究对象,所有患者均行冠状动脉CT和冠状动脉造影检查,冠状动脉CT未见粥样硬化者纳入对照组,其余患者根据冠状动脉造影结果及病史分为急性冠状动脉综合症组,稳定型心绞痛组,再根据冠状动脉CT检查结果,分为易损斑块组,混合斑块组、稳定斑块组,所有患者均行血清Hcy检测。结果易损斑块在ACS组的分布高于SAP组(P<0.05),稳定斑块在SAP组的分布高于ACS组(P<0.05)。ACS组和SAP组Hcy水平均高于对照组(P<0.05),ACS组Hcy水平高于SAP组(P<0.05)。易损斑块组、混合斑块组、稳定斑块组Hcy水平均高于对照组(P<0.05),且易损斑块组Hcy水平>混合斑块组>稳定斑块组,差异均有统计学意义(P<0.05)。结论 Hcy结合冠状动脉CT对冠状动脉斑块的不稳定性有预测价值。Objective Doubtful or diagnosed coronary heart disease patients were conducted with 64-multislice spiral computed tomography, at the same time,homocysteine （Hcy） were determined. To investigate the value of 64-MSCT combined with Hcy for estimating the stability of coronary artery plaques of patients with coronary heart disease. Methods 83 in-hospital doubtful or diagnosed coronary heart disease patients admitted to our hospital were enrolled. All patients conducted with CT tomography and coronary angiography （ CAG）, the result of CT tomography of who were negative, were divided into control group,According to the results of CAG and medical history, the others were divided into acute coronary syndrome （ACS） group, stable angina pectoris（SAP） group. According to the results of coronary artery plaques detected by MSCT, both ACS and SAP groups were further divided into vulnerable plaque group, mixed plaque group and stable plaque group. The levels of serum homocysteine （Hcy） were measured. Results The distribution of vulnerable plaques in ACS group was higher than that in SAP group（P 〈 0.05 ）, while that of stable plaques lower than in SAP group （P 〈 0.05 ）. The levels of homocysteine in SAP and ACS group were higher than those in control group （ P 〈 0. 05 ）, and there was significant difference betwween SAP and ACS groups（P 〈 0. 05）. The levels of homocysteine in every plaque group were all obviously higher than those in the control group（P 〈0. 05）,and those in vulnerable and mixed plaque group were also higher than those in stable plaque group（P 〈0. 05 ）. The levels of homocysteine in vulnerable plaque group were higher than those in mixed plaque group（P 〈0.05）. Conclusion The detection of 64-MSCT combined with homocysteine （Hcy） had predictive value of unstable coronary artery plaques.

关 键 词：多层螺旋CT 同型半胱氨酸 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]