应用冠状动脉血管内视镜对无症状性粥样斑块破裂的观察

Observation of asymptomatic plaque rupture with coronary angioscopy

目的 探讨无症状性冠状动脉粥样斑块破裂发生的频率及其与各种冠心病危险因子的关系。方法 应用冠状动脉血管内视镜连续观察 30例稳定性心绞痛及陈旧性心肌梗死患者非责任血管内粥样斑块破裂发生 ,进一步探讨其与糖尿病、高血压、高脂血症、高尿酸血症、吸烟及冠心病家族史等危险因子之间的关系。结果 30例 (41支 )非责任血管内观察到斑块破裂者 10例 (33.3% )、血管 10支 (2 4.4% ) ,其中合并糖尿病者 7例 (70 .0 % ) ,与无斑块破裂组的 5例 (2 5 .0 % )相比 ,差异有显著性 ;有合并高血压者 8例 (80 .0 % ) ,与无斑块破裂组的 7例 (35 .0 % )相比 ,差异有显著性。结论无症状性冠状动脉粥样斑块破裂占稳定性心绞痛及陈旧性心肌梗死病人的三分之一 ,并且与糖尿病。

Aims: To assess the rate of the asymptomatic plaque rupture (APR)and the correlation between APR and the risk factors of coronary heart disease(CHD) through the observation of the asymptomatic plaque rupture with angioscopy. Methods To evaluate the relations of the plaque ruptures in the non responsible vessels and the risk factors of diabetes, hypertension, hyperlipemia, hyperuricemia, smoking and family histories, 30 stable angina pectoris and old myocardial infarction cases were observed with coronary angioscopy. Results Plaque ruptures were observed in 10 (24.4%) among 41 non responsible vessels in 10 cases (33.3%). Of which,70% were accompanied with diabetes (25% in non rupture), 80% were accompanied with hypertension (35% in non rupture). There were significant difference in the frequency of hypertension and diabetes between plaque rupture and non plaque rupture(both P =0.025). Conclusions There were one third of patients who were observed APR in stable angina pectoris and old myocar dial infarction. And a significant relation between the APR and diabetes or hypertension was found in the study.