冠心病患者脂代谢生化参数及斑块特征与冠脉CTA血流储备分数的相关性  

Relationship between biochemical parameters of Lipid Metabolism,plaque characteristics and Coronary CTA flow Reserve fraction in patients with coronary heart disease

作　　者：彭超[1] 刘羽 黄英 刘欢 刘钇蔓 PENG Chao;LIU Yu;HUANG Ying;LIU Huan;LIU Yiman(Medical Imaging Department,The Fourth People's Hospital of Chongqing,Chongqing Emergency Medical Center,Chongqing 400014,China;Medical Imaging Department,Southwest University Public Health Hospital,Chongqing Public Health Medical Center,Chongqing 400036,China)

机构地区：[1]重庆市急救医疗中心·重庆市第四人民医院医学影像科,重庆400014 [2]重庆市公共卫生医疗救治中心·西南大学附属公卫医院医学影像科,重庆400036

出　　处：《西部医学》2023年第3期449-452,458,共5页Medical Journal of West China

基　　金：重庆市医学科研计划项目(2020MSXM111)。

摘　　要：目的探讨冠心病患者冠脉CT血管成像(CTA)血流储备分数(FFR_(CT))与斑块特征、脂代谢、蛋白酶分泌的相关性。方法选取2019年1月—2020年6月在重庆市急救医疗中心接受冠脉CTA检查的冠心病患者54例,根据FFR_(CT)值分为FRCT值>0.80组32例,FFR_(CT)值≤0.80组22例。测定FFR_(CT)及斑块特征参数(斑块长度、最小管腔面积、斑块总体积、脂质斑块体积、纤维斑块体积、钙化斑块体积)、脂代谢指标[低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)的含量,采用酶联免疫吸附法测定趋化素(Chemerin)、网膜素-1(Omentin-1)]、蛋白酶指标[基质金属蛋白酶(MMP)-2、MMP-9、组织蛋白酶K(CatK)、金属蛋白酶组织抑制剂(TIMP)-1、TIMP-2]。结果FFR_(CT)值>0.8的冠心病患者的斑块长度、斑块总体积、脂质斑块体积及血清LDL-C、Chemerin、MMP-2、MMP-9、CatK含量均明显低于FFR_(CT)值≤0.80的冠心病患者(P<0.05),血清HDL-C、Omentin-1、TIMP-1、TIMP-2含量明显高于FFR_(CT)值≤0.80的冠心病患者(P<0.05),纤维斑块体积、钙化斑块体积、最小管腔面积与FFR_(CT)值≤0.80的冠心病患者比较差异无统计学意义(P>0.05)。FFR_(CT)值与斑块长度、斑块总体积、脂质斑块体积、LDL-C、Chemerin、MMP-2、MMP-9、CatK具有负相关关系,与HDL-C、Omentin-1、TIMP-1、TIMP-2具有正相关关系。结论冠心病患者FFR_(CT)降低与斑块增大及稳定性下降、脂代谢紊乱、蛋白酶活性增加密切相关。Objective To study the correlation between coronary CT angiography(Computer tomography angiography,CTA)fractional flow reserve(Fractional flow reserve,FFR_(CT))and plaque characteristics,lipid metabolism,protease secretion in patients with coronary heart disease.Methods The patients with coronary heart disease who underwent coronary CTA examination in Chongqing Emergency Medical Center from June 2019 to March 2020 were selected.Then FFR_(CT),plaque characteristic parameters,lipid metabolism index and protease index were determined.Results Among 54 patients with coronary heart disease,32 patients had FFR_(CT)value>0.80 and 22 patients had FFR_(CT)value≤0.80.The plaque length,total plaque volume,lipid plaque volume and serum LDL-C,Chemerin,MMP-2,MMP-9 and CatK contents in coronary heart disease patients with FFR_(CT)value>0.8 were significantly lower than those with FFR_(CT)value≤0.80(P<0.05),and the serum HDL-C,Omentin-1,TIMP-2 contents were significantly higher than those with FFR_(CT)value≤0.80(P<0.05).There was no significant difference in fibrous plaque volume,calcified plaque and minimum lumen area with those with FFR_(CT)value≤0.80(P>0.05).FFR_(CT)value was negatively correlated with plaque length,total plaque volume,lipid plaque volume,LDL-C,Chemerin,MMP-2,MMP-9 and CatK,and positively correlated with HDL-C,Omentin-1,TIMP-1 and TIMP-2.Conclusion The decrease of FFR_(CT)in patients with coronary heart disease closely relates to the increase of plaque and decrease of stability,disorder of lipid metabolism and increase of protease activity.

关 键 词：冠心病 冠脉CT血管成像 血流储备分数 脂代谢 蛋白酶 

分 类 号：R541.4[医药卫生—心血管疾病]