血管内超声探测冠状动脉易损斑块及其与代谢综合征的关系

Relationship between Metabolic Syndrome and Plaque Vulnerability in Coronary Artery via Intravascular Ultrasound

目的:探讨代谢综合征(MS)与冠状动脉斑块易损性的关系。方法:在冠状动脉介入治疗前对63例单支罪犯病变的不稳定型心绞痛(UAP)患者进行冠状动脉造影(CAG)和血管内超声(IVUS)检查。按是否伴有MS分为MS组和非MS组。结果:(1)MS组病变部位的管腔面积小于非MS组,外弹力膜(EEM)面积、斑块面积、斑块负担均大于非MS组。(2)MS组的重塑指数大于非MS组。2组患者均以负性重塑为主,但是2组患者重塑类型的分布差异有统计学意义,正性重塑在MS组较常见,负性重塑在非MS组较常见。(3)MS组软斑块、偏心斑块、破裂斑块均多于非MS组。(4)MS组超敏C-反应蛋白(hsCRP)水平高于非MS组,差异有统计学意义。结论:MS加重冠状动脉狭窄程度并促进易损斑块形成,可能与更高的炎症水平有关。

Objective： To study the relation between metabolic syndrome （MS）and vulnerable plaque in coronary artery. Methods： Sixty-three unstable angina patients （UAP） with one-vessel criminal lesion before percutaneous coronary intervention （PCI） operation were included in the study. The patients were divided into MS group and non-MS group. Results： Vascular cavity area of lesion position in MS group was smaller than that in non-MS group, but external elastic membrane （EEM）area, plaque area and plaque burden were larger than those in non-MS group respectively. Remodeling index in MS group was higher than that in non-MS group. Most patients in two groups were negative remodeling. Remodeling type was significantly different in two groups. Positive remodeling was more common in MS group while negative remodeling was more common in non-MS group. The soft plaque, eccentric plaque and ruptured plaque in MS group were more than those in non-MS group. The level of hsCRP in MS group was higher than that in non-MS group. Conclusion：MS could make narrow degree of coronary artery more serious, plaque nature more unstable and more plaque rupture, which may be related to the higher level of inflammation.