64层螺旋CT联合尿酸、同型半胱氨酸评估冠心病患者冠状动脉斑块稳定性的临床价值  

Effect of 64 slice spiral CT combined with uric acid,homocysteine for evaluation of plaque stability in patients with coronary heart disease

作　　者：解晓江[1] 肖学慧[2] 刘艳阳[1] 宁少奇 刘挨师[4] 

机构地区：[1]内蒙古医科大学附属医院心内科,呼和浩特010059 [2]内蒙古医科大学附属医院 [3]内蒙古医科大学公共卫生学院流行病与统计学教研室 [4]内蒙古医科大学附属医院影像科,呼和浩特010059

出　　处：《疑难病杂志》2016年第1期14-17,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：内蒙古自治区高等学校科学研究项目(NJZZ097);内蒙古医科大学附属医院科研项目(NYFYYB2014023)

摘　　要：目的探讨64排螺旋CT(64-MSCT)检查联合血清尿酸(UA)、同型半胱氨酸(Hcy)水平检测对冠状动脉斑块稳定性的预测价值。方法选择2013年10月—2015年2月内蒙古医科大学附属医院心内科拟诊为冠心病的患者53例为研究对象,所有研究对象均行冠状动脉造影和冠状动脉MSCT检查,根据病史及冠状动脉造影结果分为急性冠状动脉综合征(ACS)组27例,稳定型心绞痛(SAP)组26例;根据冠状动脉MSCT检查结果,分为易损斑块组19例,混合斑块组13例和稳定斑块组21例。选择同期冠状动脉MSCT检查未见粥样硬化的患者30例为对照组,记录研究对象的一般情况,同时测定血清UA、Hcy水平。结果(1)SAP组稳定斑块分布高于ACS组(x^2=14.159,P<0.05),ACS组的易损斑块分布高于SAP组(x^2=9.294,P<0.05),混合斑块在2组间的分布差异无统计学意义(x^2=0.774,P>0.05)。(2)ACS组和SAP组UA、Hcy水平均高于对照组(P<0.05),ACS组UA和Hcy水平高于SAP组(P<0.05)。(3)易损斑块组、混合斑块组、稳定斑块组UA和Hcy水平均高于对照组,且易损斑块组>混合斑块组>稳定斑块组,差异均有统计学意义(P<0.05)。结论冠状动脉64-MSCT可以较准确地显示冠状动脉斑块的性质,UA、Hcy与冠状动脉斑块不稳定性关系密切,可反映冠状动脉斑块的不稳定性;冠状动脉MSCT结合UA、Hcy对冠状动脉斑块的不稳定性有预测价值。Objective To investigate the predictive value of the 64 slice spiral CT（64-MSCT） combined with serum uric acid（UA） and homocysteine（Hcy） for detection of coronary artery plaque stability.Methods 53 patients with coronary heart disease were selected from October 2013 to February 2015.All patients underwent coronary angiography and coronary MSCT examination.According to medical history and coronary angiography,patients were divided into acute coronary syndrome（ACS） group（n =27） and stable angina pectoris（SAP） group（n =26）.According to the results of MSCT,patients were divided into vulnerable plaque group（n = 19）,mixed plaques group（n = 13） and stable plaques group（n =21）.30 cases of patients with coronary artery MSCT were selected as control group,the general condition of the study subjects were recorded,and the levels of serum Hcy and UA were measured.Results（1） Distribution of stable plaque in SAP group was higher than that in ACS group（χ^2 = 14.159,P〈0.05）,and the distribution of vulnerable plaque in ACS group was higher than those in SAP group（χ^2 =9.294,P〈0.05）,and the distribution of mixed plaque between the two groups showed no statistical significance differences（χ^2=0.774,P〈0.05）.（2） ACS group and SAP group＇s UA,Hcy levels were higher than those of the control group（P〈0.05）,the distribution of ACS groups UA and Hcy were higher than those in SAP group（P〈0.05）;（3） Vulnerable plaque group,mixed plaque group,stable plaque groups UA and Hcy levels were higher than the control group and vulnerable plaque group 〉mixed plaque block〉 stable plaque group,the differences were statistically significant（P〈0.05）.Conclusion 64-MSCT can display the properties of coronary artery plaque,and the relationship between Hcy and UA is closely related to the instability of coronary artery plaque,which can reflect the instability of coronary artery plaque.MSCT combined of UA and Hcy can predict the coronary artery instability plaque.

关 键 词：64层螺旋CT 尿酸 同型半胱氨酸 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]