急性冠脉综合征患者斑块性质与血管重构的血管内超声研究

Intravascular ultrasound research on relationship between plaque characteristics and vascular remodeling in patients with borderline acute coronary syndrome

目的探讨冠脉造影显示冠脉临界病变的急性冠脉综合征患者斑块性质与血管重构关系的血管内超声研究。方法对于冠脉造影显示冠脉狭窄病变程度在40%～70%的急性冠脉综合征患者同时行IVUS检查,入选患者94例,行临床基线资料采集、IVUS测量数据,根据重构指数（RI）分组,RI〉1为正性重构组,RI〈1为负性重构组,RI=1为无重构组。结果软斑块在正性重构组（20例）的比例明显高于负性重构（7例）及无重构组（2例）,差异有统计学意义（P〈0.05）;钙化斑块在负性重构组（15例）的比例明显高于正性重构（5例）及无重构组（2例）,差异有统计学意义（P〈0.01）;正性重构组最小管腔面积处的EEM明显大于其余2组,差异有统计学意义（P〈0.05）。结论血管正性重构病变部位更多为软斑块,钙化斑块较少,负性重构则相反。

Objective To carry out the intravascular ultrasound research on the relationship between plaque char- acteristics and vascular remodeling in the patients with borderline acute coronary syndrome. Methods A total of 94 pa- tients who had lesions of intermediate severity （40%-70% diameter stenosis） in coronary Atheroscierotic （CAG） were en- rolled. The baseline clinical characteristics were collected. All the patients underwent quantitative coronary angiography （QCA） and IVUS assessment of the lesions in the artery. According to the remodeling index （R1）, 94 patients were divided into three groups, RI 〉 1 as a positive remodeling group, Pd〈 1 as a negative remodeling group, and RI = 1 as no remodel- ing group. Results The soft plaque in the positive remodeling group （20 cases） was significantly higher than that of the negative remodeling group （7 cases） and no remodeling group （2 cases）, and the difference was statistically significant （P = 0.016）; the calcified plaque in the negative remodeling group （15 cases） was significantly higher than that of the positive remodeling group （5 cases） and no remodeling group （2 cases）, and the difference was statistically significant （P = 0.009）; EEM of minimal lumen area of the positive remodeling group was significantly greater than that in the other two groups, and the difference was statistically significant （P = 0.038）. Conclusion The intravaseular ultrasound analysis shows that the lesions with positive remodeling have statistically more soft plaque and less calcified plaque, whereas, those with negative remodeling are opposite.