经皮冠状动脉介入治疗患者心肌损伤标志物变化与斑块组织成分的关系

Correlation between plaque composition and myocardial damage of percutaneous coronary intervention patients

目的探讨经皮冠状动脉介入术（PCI）治疗不稳定型心绞痛时心肌损伤标志物变化与斑块组织成分的关系。方法对30例不稳定型心绞痛患者进行冠状动脉造影和虚拟组织学成像血管内超声（VH—IVUS）检查，测定PCI术前、术后0．5h及12h的缺血修饰白蛋白（IMA）、肌钙蛋白I（cTnI）血清浓度。结果①PCI患者术后0．5h的INA、术后12h的eTnI血清水平较术前明显升高[分别是（103．05＋9．48）比（113．05＋8．97）IU／nll；（0．085＋0．035）比（0．221＋0．042）ng／ml，P〈0．05]。②斑块纤维脂质组织面积百分比与术后IMA的血清水平呈正相关（r=0．403，P〈0．05）。斑块坏死核组织面积百分比与术后IMA、cTnI血清水平呈正相关（分别是r=0．374，r=0．448，P〈0．05）。结论PCI会导致不稳定型心绞痛患者心肌损伤，心肌损伤与斑块坏死核大小有关。

Objective To explore the relationship bctv/een coronary artery plaque composition which was analized through virtual histology intravascular ultrasound （VH-IVUS） and the changes of ischemia modified albu- min （IMA）, cardiac troponin-I （cTnI） after percutaneous coronary intervention （PCI） in patients with unstable angina. Methods 30 patients underwent VH-IVUS before PCI were included. Blood sample was taken before and 0.5 h and 12 h after PCI to test the serum concentration of IMA, cTnI separately. Results （1）The serum level of IMA at 0.5 h, cTnI at 12 h went up post PCI [seperately, （103.05±9.48）IU/ml vs （113.05±8.97）IU/ml, （0.085±0.035）ng/ml vs （0.221±0.042）ng/ml, P〈0.05 ]. （2）Positive correlation was found between the percentage of fibro-fatty area and the serum level of IMA （r=0.403, P〈0.05）. Meanwhile, a positive correlation was showed between the percentage of necrotic core area and the serum levels of IMA and cTnI （seperately, r=0.374, r= 0.448, P〈0.05）. Conclusion In unstable angina patient, PCI may result in myocardial damage, and that may relate to the magnitude of the plaque necrotic core.