急性冠状动脉综合征患者胆固醇代谢标志物与罪犯血管斑块易损性的相关性研究

Association between cholesterol metabolism markers level and coronary plaque vulnerability of target vessels in acute coronary syndrome patients

目的:探讨急性冠状动脉综合征(ACS)患者胆固醇代谢标志物与罪犯血管虚拟组织学-血管内超声特点的相关性。方法:入选4周内未接受过调脂治疗的ACS的患者共55例,根据血管虚拟组织学-血管内超声检查确定有无薄帽纤维粥样硬化斑块(TCFA),将患者分为两组,比较两组患者斑块组分及胆固醇代谢标志物水平的差异。结果:TCFA(+)组罪犯病变斑块的纤维脂质、坏死核心、钙化成分较TCFA(-)组显著增高,[分别为18.55(12.20,46.77)vs.12.60(4.31,16.39)mm^3,P=0.002;44.88(35.06,68.82)vs.25.97(15.23,28.98)mm^3,P=0.000;3.20(1.03,4.70)vs.1.30(0.80,2.50)mm^3,P=0.015]。谷固醇与罪犯病变斑块的坏死体积、钙化体积成正相关。结论:胆固醇吸收标志物水平可能与冠状动脉斑块的易损性呈正相关。

Objective： To study the relationship between cholesterol metabolism markers and coronary plaque vulnerability of target vessels in ACS patients. Association between cholesterol metabolism markers level and coronary plaque vulnerability of target vessels in ACS patients. Methods ： Fifty-five ACS patients who had not received antilipemic therapy for 4 weeks were recruited and divided into 2 groups based on presence of thin cap fibroatheroma （TCFA） in target vessels assessed by the use of virtual histology intravascular ultrasound, and the differences of plaque characteristics and cholesterol metabolism markers between the two groups were studied. Results： The volumes of fibro-fatty, necrotic core and dense calcified tissue are remarkable larger in the TCFA（ ＋ ） group [ 18.55 （ 12.20,46.77 ） vs. 12.60 （ 4.31,16.39 ） mm3 , P = 0. 002 ; 44.88 （ 35.06, 68.82） vs. 25.97 （15.23,28.98） mm3 , P = 0. 0130 ; 3.20 （ 1.03,4.70 ） vs. 1.30 （ 0.80,2.50 ） mm3 , P = 0. 015]. The level of sitosterol is positively associated with the volume of necrotic score and dense calcified tissue in the target vessels. Conclusion： Enhanced cholesterol absorption may be positively related to coronary plaque vulnerability.