hs-CRP、D-二聚体和Lp-PLA2与冠心病患者冠状动脉粥样硬化易损斑块的相关性

Correlation of Serum Hs-CRP, D-dimmer and Lp-PLA2 Levels with Vulnerable Plaque of Coronary Artery Atherosclerosis in Patients with Coronary Heart Disease

目的:研究超敏C反应蛋白(hs-CRP)、D-二聚体和脂蛋白相关磷脂酶A2(Lp-PLA2)与冠心病患者冠状动脉粥样硬化易损斑块的相关性。方法:选择2014年1月~2016年12月在我院进行冠状动脉造影和血管内超声检查的患者106例,按照检查结果分为易损斑块组、稳定斑块组和对照组。检测和比较三组患者的血清hs-CRP、D-二聚体和Lp-PLA2水平,并采用Pearson相关分析探讨其与纤维帽厚度、斑块偏心指数和血管重构指数的相关性。结果:易损斑块组和稳定斑块组的血清hs-CRP、D-二聚体和Lp-PLA2水平明显高于对照组(P<0.05),且易损斑块组的血清hs-CRP、D-二聚体和Lp-PLA2水平明显高于稳定斑块组(P<0.05)。hs-CRP与纤维帽厚度呈负相关(r=-0.712,P<0.05),与斑块偏心指数和血管重构指数呈正相关(r=0.813,0.756,P<0.05);D-二聚体与纤维帽厚度呈负相关(r=-0.654,P<0.05),与斑块偏心指数和血管重构指数呈正相关(r=0.912,0.853,P<0.05);Lp-PLA2与纤维帽厚度呈负相关(r=-0.796,P<0.05),与斑块偏心指数和血管重构指数呈正相关(r=0.836,0.729,P<0.05)。结论:hs-CRP、D-二聚体和Lp-PLA2与冠心病患者冠状动脉粥样硬化易损斑块具有较高的相关性,可作为评估冠状动脉粥样斑块不稳定性的参考指标。

Objective： To investigate the correlation of serum hs-CRP, D- dimmer and Lp-PLA2 with vulnerable plaque of coronary artery atherosclerosis in patients with coronary heart disease. Methods： Selected 106 cases of patients in our hospital from January 2014 to December 2015, all taken coronary angiography and intravascular ultrasound. Divided into three groups according to the results of the examination, the levels of serum hs-CRP, D- dimmer and Lp-PLA2 were examined and compared, and the correlation with fiber cap thickness, plaque eccentricity index, and vascular remodeling index were tested by Pearson correlation analysis. Results： Serum levels Ofhs-CRP, D- dimmer and Lp-PLA2 of vulnerable plaque group and stable plaque group were significantly higher than that of the control group （P〈0.05）, and the serum levels ofhs-CRP, D- dimmer and Lp-PLA2 ofvuinerable plaque group were significantly higher than that of stable plaque group （P〈0.05）; hs-CRP was negative correlated with the thickness of fibrous cap （r= -0.712, P〈0.05）, and positive correlated with eccentric plaque index and vascular remodeling index （r=0.813, 0.756; D-, P〈0.05）, D- dimmer was negative correlated with the thickness of fibrous cap （r=-0.654, P〈0.05）, and positive correlated with eccentric plaque index and vascular remodeling index （r=0.912, 0.853, P〈0.05）; Lp-PLA2 was negative correlated with the thickness of fibrous cap （r=-0.796, P〈0.05）, and positive correlated with eccentric plaque index and vascular remodeling index （r=0.836, 0.729, P〈0.05）. Conclusion： Hs-CRP, D-dimmer and Lp-PLA2 have high correlation with vulnerable plaque in coronary artery disease, can be used as reference indexes for assessing the instability of coronary atherosclerotic plaque.