血清血小板源性生长因子与冠状动脉粥样硬化斑块超声显像特征的相关性研究

Correlation between serum PDGF and ultrasound imaging of coronary atherosclerotic plaque

目的:探讨不同类型冠心病患者冠状动脉(冠脉)内粥样硬化斑块的性质及其与血清血小板源性生长因子(PDGF)浓度的关系。方法:选取胜利油田中心医院住院并行冠脉造影检查的患者106例为研究对象,其中急性冠脉综合征(ACS)组60例,稳定型心绞痛(SAP)组46例。采用ELISA法检测血清PDGF水平,对所有研究对象的143支病变冠脉进行IVUS检查,比较ACS组与SAP组斑块性质、斑块破裂和血栓形成发生率、正性重构比率、外弹力膜面积以及偏心指数等的差异,以及不同性质斑块血清PDGF浓度的差异。结果:ACS组血清PDGF浓度显著高于SAP组(P<0.05)。与SAP组比较,ACS组斑块以软斑块为主,斑块破裂和血栓形成发生率高,斑块以偏心斑块为主,偏心指数低,正性重构发生率高(均P<0.05)。两组外弹力膜面积差异无统计学意义。纤维斑块、钙化斑块、混合斑块(硬斑块)血清PDGF水平均低于软斑块(P<0.05)。结论:PDGF参与冠脉粥样硬化斑块的形成,在ACS的发病中起着重要作用,斑块越不稳定,PDGF的浓度越高,检测血清PDGF浓度有助于诊断和预测ACS的发生。

Objective：To detect the relationship between the serum concentrations of platelet derived growth factor（PDGF）with the different types of atherosclerotic plaques in patients with coronary heart disease.Method：Sixty cases with acute coronary syndrome（ACS group）and 46 cases with stable angina pectoris（SAP group）underwent coronarography was included.ELISA was used to detect the serum concentration of PDGF levels,all the143 lesions of coronary artery was examined by IVUS.The plaque properties,rupture and thrombosis incidence,positive remodeling ratio,external elastic membrane area,eccentric index,as well as the serum PDGF concentrations in different plaques between the two groups was compared.Result：The serum PDGF concentration in ACS group was significantly higher than that in SAP group（P〈0.05）.Compared with SAP group,the plaque of ACS group was mainly soft plaque,the incidence of plaque rupture and thrombosis was higher,the plaque was dominated by eccentric plaque,and the incidence of positive remodeling was higher（all P〈0.05）.There was no significant difference in the area of elastic membrane between the two groups.The serum levels of PDGF in fibrous plaque,calcified plaque and mixed plaque（hard plaque）were lower than those in soft plaque（P〈0.05）.Conclusions：PDGF is involved in the formation of atherosclerotic plaque,which plays an important role in the pathogenesis of ACS.This study shows that the more unstable plaque,the higher the concentration of PDGF,suggesting that the detection of serum PDGF concentration is helpful to diagnose and predict the occurrence of ACS.