慢性冠脉综合征患者冠脉易损斑块的危险因素分析  

Risk factors for coronary vulnerable plaque in patients with chronic coronary syndrome

作　　者：安红萤 刘弢 王威仪[1] 何畅 简新闻 樊泽元[1] 季汉华[1] AN Hong-ying;LIU Tao;WANG Wei-yi;HE Chang;JIAN Xin-wen;FAN Ze-yuan;JI Han-hua(Department of Cardiology,Civil Aviation Clinic Medical School of Peking University,Beijing,100123,China)

机构地区：[1]北京大学民航临床医学院心内科,北京市100123

出　　处：《心血管康复医学杂志》2022年第3期295-299,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：民航安全能力建设资金基金项目(DFS20180601)。

摘　　要：目的:研究慢性冠脉综合征(CCS)患者冠脉易损斑块的危险因素。方法:依据血管内超声VH-IVUS图像,于我院治疗的126例CCS患者被分为稳定斑块组(57例)与易损斑块组(69例),观察比较两组一般临床资料,并分析易损斑块的危险因素。结果:与稳定斑块组比较,易损斑块组血浆空腹血糖(FBG)、低密度脂蛋白胆固醇、高敏C反应蛋白(hsCRP)、髓过氧化物酶(MPO)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平均显著升高,血浆高密度脂蛋白胆固醇水平显著降低(P<0.05或<0.01)。多因素Logistic回归分析显示,MPO、Lp-PLA2、hsCRP、FBG为CCS患者易损斑块的独立危险因素(OR=1.023~7.544,P<0.05或<0.01)。MPO、Lp-PLA2、hsCRP、FBG单独检测及四者联合检测诊断冠脉易损斑块的曲线下面积分别为0.886、0.914、0.889、0.610、0.991,灵敏度分别为68.1%、87.0%、79.7%、44.9%、97.1%,特异度分别为93.0%、91.2%、91.2%、87.7%、94.7%。结论:血浆MPO、Lp-PLA2、hsCRP、FBG均为慢性冠脉综合征患者冠脉易损斑块的独立危险因素,联合检测更有助于易损斑块的早期识别。Objective:To study risk factors for coronary vulnerable plaque in patients with chronic coronary syndrome(CCS).Methods:According to intravascular ultrasound VH-IVUS images,a total of 126 CCS patients treated in our hospital were divided into stable plaque group(n=57)and vulnerable plaque group(n=69).General clinical data were observed and compared between two groups,and risk factors of vulnerable plaques were analyzed.Results:Compared with stable plaque group,there were significant rise in plasma levels of fasting blood glucose(FBG),low-density lipoprotein cholesterol,high-sensitivity C-reactive protein(hsCRP),myeloperoxidase(MPO)and lipoprotein-related phospholipase A2(Lp-PLA2),and significant reduction in plasma level of high-density lipoprotein cholesterol in vulnerable plaque group(P<0.05 or<0.01).Multivariate Logistic regression analysis indicated that MPO,Lp-PLA2,hsCRP and FBG were independent risk factors for vulnerable plaque in CCS patients(OR=1.023~7.544,P<0.05 or<0.01).Areas under curve(AUC)of single MPO,Lp-PLA2,hsCRP,FBG detection and quad-detection for diagnosis of coronary vulnerable plaques was 0.886,0.914,0.889,0.610 and 0.991 respectively,sensitivities of them was 68.1%,87.0%,79.7%,44.9%and 97.1%respectively,and specificities of them was 93.0%,91.2%,91.2%,87.7%and 94.7%respectively.Conclusion:Plasma MPO,Lp-PLA2,hsCRP,and FBG are independent risk factors for coronary vulnerable plaques in patients with chronic coronary syndrome,and their combined detection is more helpful for early recognition of vulnerable plaques.

关 键 词：冠状动脉疾病 斑块 动脉粥样硬化 过氧化物酶 

分 类 号：R541.409[医药卫生—心血管疾病]