64层螺旋CT联合炎症因子检测急性冠状动脉综合征患者易损斑块的相关研究

被引：4

作者：

杨丽霞 ^{[1
]}

郑甲林 ^{[1
]}

严睿 ^{[2
]}

齐峰 ^{[1
]}

机构：

[1] 成都军区昆明总医院心血管内科

[2] 成都军区昆明总医院医学影像科

来源：

中国介入心脏病学杂志 | 2009年 / 17卷 / 06期

关键词：

冠状动脉疾病; 体层摄影术,螺旋计算机; C反应蛋白质; 基质金属蛋白酶类;

D O I：

暂无

中图分类号：

R541.4 [冠状动脉（粥样）硬化性心脏病（冠心病）];

学科分类号：

摘要：

目的评价64层螺旋CT联合炎症因子高敏C反应蛋白(hs-CRP)及基质金属蛋白酶9(MMP-9)检测急性冠状动脉综合征(ACS)患者易损斑块的临床价值。方法入选72例冠心病患者,其中ACS组43例,稳定型心绞痛(SAP)组29例,进行64层螺旋CT冠状动脉成像,根据CT值将ACS组、SAP组犯罪血管处斑块分为软斑块、纤维斑块、钙化斑块。同时检测患者血清hs-CRP及血浆MMP-9浓度,并进行选择性冠状动脉造影检查,明确冠状动脉病变部位及性质。对照组25例。结果(1)ACS组软斑块发生率较SAP组明显高,差异有统计学意义(24/43比4/29,P=0.001);(2)与对照组比较,SAP、ACS组hs-CRP(4.12±2.82mg/L比6.11±2.60mg/L比11.26±3.03mg/L)、MMP-9(54.87±47.73ng/mL比91.69±55.72ng/mL比187.86±64.73ng/mL)浓度明显升高,差异有统计学意义(P均<0.05);且ACS组较SAP组升高更明显,差异有统计学意义(P<0.05);(3)冠心病的软斑块亚组与纤维斑块、钙化斑块亚组比较hs-CRP(12.69±2.41mg/L比7.47±2.52mg/L比6.39±2.87mg/L)、MMP-9(211.67±57.87ng/mL比121.48±55.86ng/mL比95.99±62.29ng/mL)浓度明显升高,差异有统计学意义(P均<0.05);(4)冠心病患者冠状动脉斑块CT值与hs-CRP、MMP-9浓度呈负相关。结论联合检测炎症因子hs-CRP及MMP-9,能够提高64层螺旋CT检测ACS患者冠状动脉斑块性质的准确性,并提示斑块稳定性,提高对ACS的诊断率。

引用

页码：316 / 319

页数：4

共 6 条

[1] Comparison of 64-Slice Multidetector Computed Tomography With Spectral Analysis of Intravascular Ultrasound Backscatter Signals for Characterizations of Noncalcified Coronary Arterial Plaques [J].

Choi, Byoung-Joo ;

Kang, Doo-Kyoung ;

Tahk, Seung-Jea ;

Choi, So-Yeon ;

Yoon, Myeong-Ho ;

Lim, Hong-Seok ;

Kang, Soo-Jin ;

Yang, Hyoung-Mo ;

Park, Jin-Sun ;

Zheng, Mingri ;

Hwang, Gyo-Seung ;

Shin, Joon-Han .

AMERICAN JOURNAL OF CARDIOLOGY, 2008, 102 (08) :988-993

[2] Usefulness of 64-slice cardiac computed tomographic angiography for diagnosing acute coronary syndromes and predicting clinical outcome in emergency department patients with chest pain of uncertain origin [J].

Rubinshtein, Ronen ;

Halon, David A. ;

Gaspar, Tamar ;

Jaffe, Ronen ;

Karkabi, Basheer ;

Flugelman, Moshe Y. ;

Kogan, Asia ;

Shapira, Reuma ;

Peled, Nathan ;

Lewis, Basil S. .

CIRCULATION, 2007, 115 (13) :1762-1768

[3]

Assessment of coronary plaque morphology by contrast-enhanced computed tomographic angiography: comparison with intravascular ultrasound[J] . Margaret Leila Rasouli,David M. Shavelle,William J. French,Charles R. McKay,Matthew J. Budoff.Coronary Artery Disease . 2006 (4)

[4]

Accuracy of multidetector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques[J] . Alexander W Leber,Andreas Knez,Alexander Becker,Christoph Becker,Franz von Ziegler,Konstantin Nikolaou,Carsten Rist,Maximilian Reiser,Carl White,Gerhard Steinbeck,Peter Boekstegers.Journal of the American College of Cardiology . 2004 (7)

[5]

Multiple Plaque Rupture in Acute Coronary Syndrome[J] . H. Richard Hellstrom.Circulation: Journal of the American Heart Association . 2003 (9)

[6]

Non-invasive characterisation of coronary lesion morphology and composition by multislice CT: first results in comparison with intracoronary ultrasound[J] . Andreas F. Kopp,Stephen Schroeder,Andreas Baumbach,Axel Kuettner,Christian Georg,Bernd Ohnesorge,Martin Heuschmid,Ronald Kuzo,Claus D. Claussen.European Radiology . 2001 (9)

← 1 →