光学相干断层扫描下观察不同性别老年稳定心绞痛患者罪犯血管内的斑块特点  

Optical coherence tomography applied for observing plaque characteristics in culprit vessels in elderly patients of different genders with stable angina pectoris

作　　者：赵祖亮 刘肖肖[2] 陈亮[2] 叶新和[2] 杨承健[2] Zhao Zuliang;Liu Xiaoxiao;Chen Liang;Ye Xinhe;Yang Chengjian(Department of Cardiovascular Medicine,Xishan People's Hospital,Wuxi City,214105,China;不详)

机构地区：[1]无锡市锡山人民医院心血管内科,无锡214105 [2]南京医科大学附属无锡市第二人民医院心血管内科,无锡214002

出　　处：《中国循证心血管医学杂志》2021年第12期1513-1517,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的通过光学相干断层扫描(OCT)探讨不同性别老年稳定性心绞痛患者罪犯血管的斑块特点。方法回顾性收集分析2018年10月至2020年6月于南京医科大学附属无锡市第二人民医院心血管内科住院的老年稳定性心绞痛患者83例,通过OCT扫描描绘罪犯血管内斑块的类别(纤维斑块、脂质斑块、钙化斑块)。根据性别分为男性组与女性组,采用多因素二元Logistic回归分析低密度脂蛋白、性别与老年稳定性心绞痛患者罪犯血管斑块类型为脂质斑块的相关性。结果相比于男性组,女性组低密度脂蛋白胆固醇[2.59(1.92~3.33)mmol/L vs.2.08(1.58~2.55)mmol/L,P<0.05]更高;总胆固醇[4.12(3.42~5.38)mmol/L vs.3.44(2.97~4.05)mmol/L,P<0.05]更高;罪犯血管内纤维斑块比例[2(7.69%)vs.22(38.60%),P<0.05]更低;脂质斑块比例[14(53.84%)vs.14(24.56%),P<0.05]更高;脂质斑块容积[2369.50(1102.00~3216.50)mm×°vs.862.84(608.50~1305.50)mm×°,P<0.05]更大;脂质斑块纤维帽厚度[(69.14±15.50)μm vs.(106.43±32.96)μm,P<0.05]更薄;薄纤维帽脂质斑块比例[6(23.08%)vs.1(1.75%),P<0.05]更高;男性组罪犯血管内斑块类型为脂质斑块的发生率减少64.4%(OR=0.356,95%CI:0.127~0.993,P<0.05)。结论女性稳定性心绞痛患者较男性罪犯血管内斑块有更大易损性,性别与老年稳定性心绞痛患者罪犯血管内斑块类型为脂质斑块的发生率有独立相关性,可更好解释不同性别老年稳定性心绞痛患者的风险性。Objective To discuss the plaque characteristics in culprit vessels by using optical coherence tomography(OCT)in elderly patients of different genders with stable angina pectoris(SAP).Methods SAP patients(n=83)were chosen from Department of Cardiovascular Medicine in the Second People’s Hospital of Wuxi City affiliated to Nanjing Medical University from Oct.2018 to June 2020.The types of plaques in culprit vessels(including fibrous plaques,lipid plaques,calcified plaques)were imaged by using OCT.he patients were divided,according to gender,into male group and female group.The correlation among low-density lipoprotein-cholesterol(LDL-C),gender and lipid plaques was analyzed by using multi-factor binary Logistic regression analysis.Results Compared with the male group,the LDL cholesterol in the female group was higher[2.59(1.92~3.33)mmol/L vs.2.08(1.58~2.55)mmol/L,P<0.05];total cholectin was[4.12(3.42~5.38)mmol/L vs.3.44(2.97~4.05)mmol/L,P<0.05]higher;the proportion of intradascular fibrous plaque in criminals[2(7.69%)vs.22(38.60%),P<0.05]was lower;the proportion of lipid plaques[14(53.84%)vs.14(24.56%),P<0.05]was higher;the lipid plaque volume[2369.50(1102.00~3216.50)mm×°vs.862.84(608.50~1305.50)mm×°,P<0.05]was bigger;the fibrous cap thickness of lipid plaques[(69.14±15.50)μm vs.(106.43±32.96)μm,P<0.05]was thinner;the proportion of thin fibrous cap plaques[6(23.08%)vs.1(1.75%),P<0.05]was higher.In the male group.The incidence rate of lipid plaques among plaque types in culprit vessels was reduced by 64.4%in male group(OR=0.356,95%CI:0.127~0.993,P<0.05).Conclusion The plaques in culprit vessels have higher vulnerability in female SAP patients compared with male SAP patients.The incidence rate of lipid plaques among plaque types in culprit vessels and gender have an independent correlation,which can explain better the risk in elderly SAP patients of different genders.

关 键 词：性别 老年 稳定性心绞痛 斑块特点 光学相干断层扫描 

分 类 号：R541.4[医药卫生—心血管疾病]