冠状动脉易损斑块血管内超声形态特征及患者血浆高敏C反应蛋白和基质金属蛋白酶9水平对其预测作用  

Morphological features of vulnerable plaque in intravascular ultrasound and predictive value of levels of high-sensitivity C-reactive protein and matrix metalloproteinase 9 in plasma

作　　者：吴溪[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抢救中心,100029

出　　处：《中国医药》2016年第2期158-161,共4页China Medicine

基　　金：首都医学发展科研基金（2009-3022）

摘　　要：目的探讨冠状动脉易损斑块的血管内超声（IVUS）形态特征及患者血浆高敏c反应蛋白（hs—CRP）、基质金属蛋白酶9（MMP-9）水平对其预测作用。方法选取2007年3月至2010年12月首都医科大学附属北京安贞医院心内科接受IVUS检查的患者76例。根据IVUS结果将患者分为稳定斑块组和易损斑块组，比较二者IVUS特征；检测并比较2组患者血浆hs—CRP及MMP-9水平。结果易损斑块组患者26例、稳定斑块组患者50例。易损斑块组软斑块比例明显高于稳定斑块组[38．5％（10／26）比8．0％（4／50）]，斑块负荷明显大于稳定斑块组[（64±10）％比（56±14）％]，差异有统计学意义（P〈0．05）；易损斑块组以正性重构／无重构为主[正性重构：23．1％（6／26），无重构：34．6％（9／26），负性重构：42．3％（11／26）]，稳定斑块组以负性重构为主[正性重构：10．0％（5／50），无重构：12．0％（6／50），负性重构：78．0％（39／50）]，差异有统计学意义（P〈0．05）。易损斑块组患者hs—CRP及MMP-9水平明显高于稳定斑块组[（3．5±3．1）mg,／L比（2．2±1．7）mg／L，（85．8±2．1）μg／L比（54．2±2．0）μg/L]，差异有统计学意义（P〈0．05）。结论IVUS中，与冠状动脉稳定斑块相比，易损斑块软斑块比例更高、斑块负荷更大；易损斑块患者血浆hs．CRP及MMP-9水平明显高于稳定斑块患者，对易损斑块有一定预测作用。Objective To explore the morphological features of vulnerable plaque in intravascular ultrasound （IVUS） and the predictive value of the levels of high-sensitivity C-reactive protein （hs-CPR） and matrix metalloproteinase 9 （MMP-9） in plasma. Methods Totally 76 patients who underwent IVUS from March 2007 to December 2010 were enrolled. According to the IVUS results, the patients were divided into stable plaque group and vulnerable plaque group. The features of plaque in IVUS, the levels of hs-CRP and MMP-9 were compared between groups. Results There were 26 cases in vulnerable plaque group, 50 cases in stable plaque group. The proportion of soft plaque and plaque burden in vulnerable plaque group were significantly higher than those in stable plaque group [38.5% （10/26） vs8.0% （4/51）, （64±10）% vs （56±14）%] （P〉0.05）; the remodeling type was mainly positive remodeling/non remodeling in vulnerable plaque group [ positive remodeling： 23.1% （6/26）, non remodeling： 34. 6% （9/26）, negative remodeling： 42. 3% （11/26） ], was mainly negative remodeling in stable plaque group [ positive remodeling ： 10. 0% （ 5/50）, non remodeling： 12. 0% （6/50）, negative remodeling： 78.0% （39/50） ], with significant difference between group （ P 〈 0. 05 ）. The levels of hs- CRP and MMP-9 in vulnerable plaque group were significantly higher than those in stable plaque group [ （3.5± 3. 1） mg/Lvs （2.2±1.7） mg/L, （85.8±2. 1） μg/L vs （54.2±2.0） μg/L] （P〈0.05）. Conclusions In IVUS, the soft plaque proportion and plaque burden of coronary artery vulnerable plaque are higher compared with stable plaque; the blood levels of hs-CRP and MMP-9 are significantly higher in patients with vulnerable plaque than those in patients with stable plaque, and they has certain predictive function for coronary artery vulnerable plaques.

关 键 词：易损斑块 血管超声 高敏C反应蛋白 基质金属蛋白酶9 

分 类 号：R541.4[医药卫生—心血管疾病]