H型高血压患者斑块特征与同型半胱氨酸相关性研究  

Study on the relationship between plaque imaging characteristics and homocysteine in patients with Htype hypertension

作　　者：梅百强[1] 杨希立[1] 许兆延[1] 梁茜[1] 岑锦明[1] 周昭仑[1] 李健民[1] 李健[1] 蔡炜标[1] 

机构地区：[1]中山大学附属佛山市第一人民医院心内科,广东佛山528000

出　　处：《介入放射学杂志》2016年第1期70-73,共4页Journal of Interventional Radiology

基　　金：佛山市卫生和计生局医学科研项目(2015376)

摘　　要：目的对冠状动脉造影显示轻中度狭窄病变作血管内超声(IVUS)检查,分析H型高血压患者冠状动脉粥样硬化斑块形态特征,探讨同型半胱氨酸(Hcy)水平与病变程度的关系及临床意义。方法回顾性分析H型高血压患者42例和单纯高血压患者38例。所有患者均接受血浆Hcy水平检测,IVUS分别检测冠状动脉病变段和正常参考段外弹力膜横截面积(EEMCSA)、最小管腔横截面积(MLA)、斑块面积(PA)、斑块负荷(PB)等,并作定性指标和定量指标分析。结果 H型高血压组患者冠状动脉病变处软斑块、偏心斑块和正性重构多见,钙化少;单纯高血压组患者斑块多表现为纤维斑块、钙化、无重构和负性重构(P<0.05)。H型高血压组患者病变段MLA<单纯高血压组患者,EEMCSA、PA、PB>单纯高血压组患者(P<0.05);H型高血压组患者正常参考段MLA<单纯高血压组患者,RPA、RPB>单纯高血压组患者(P<0.05)。病变段Hcy水平与病变段PA、PB呈正相关(P<0.05),与病变段MLA呈负相关(P<0.05)。结论 IVUS对评价轻中度病变有较高价值,H型高血压患者冠状动脉病变程度较单纯高血压患者严重和弥漫。Hcy水平对判断冠状动脉病变程度有一定价值,高Hcy水平可能是导致斑块不稳定的因素之一。Objective By using intravascular ultrasound （IVUS） examination for patients with mild to moderate coronary artery stenosis confirmed by coronary angiography （CAG） to analyze the morphologic characteristics of coronary atherosclerotic plaques in patients with H- type hypertension, to investigate the relationship between homocysteine （Hcy） levels and the severity of the disease and to discuss its clinical significance. Methods A total of 42 patients with-H type hypertension and another 38 patients with simple hypertensi on were enrolled in this study. Serum Hcy levels were determined in all patients. The external elastic membrane cross-sectional area （EEMCSA）, the minimal lumen cross-sectional area （MLA）, the plaque area （PA）, the plaque burden （PB）, etc. of the coronary lesions and normal reference segments were measured by IVUS; the qualitative and quantitative index analysis was also conducted. Results In H-type hypertension group, soft plaque, eccentric plaque and positive remodeling with less calcification were more often seen at the diseased coronary site; while in the simple hypertension group, fibrous plaque, calcification, no reconstruction and negative remodeling were observed more frequently; the difference between the two groups was statistically significant （P〈0.05）. The MLA of H-type hypertension group was smaller than that of the simple hypertension group, while EEMCSA, PA and PB of H- type hypertension group were larger than those of the simple hypertension group （P〈0.05）. The MAL of the normal reference segments in H-type hypertension group was smaller than that in the simple hypertension group, while PA and PB of the reference segments in H-type hypertension group were larger than those in the simple hypertension group （P〈0.05）. A parallel relationship existed between the serum Hcy levels and PA, PB of diseased segments （P〈0.05）, while a negative correlation existed between the serum Hcy levels and MLA of diseased segments （P〈0.05）. Conclus

关 键 词：H型高血压 同型半胱氨酸 冠状动脉造影术 血管内超声 动脉粥样硬化 

分 类 号：R544.1[医药卫生—心血管疾病]