冠心病患者CT冠状动脉造影斑块性质与血小板功能、血清生化指标的相关性

The correlation of CT coronary angiography plaque properties with platelet function and serum biochemical indexes in patients with coronary heart disease

目的:研究冠心病患者CT冠状动脉造影斑块性质与血小板功能、血清生化指标的相关性。方法:选择2015年3月~2017年10月期间在天门市第一人民医院接受CT冠状动脉造影检查并诊断为冠心病的101位患者作为研究对象,根据CT结果将患者分为3组:软斑块(28例)、混合斑块(33例)、钙化斑块(40例);测定血清中血小板功能指标、血脂及炎症生化指标的含量。结果:软斑块、混合斑块患者血清中血小板活化因子(PAF)、血小板P选择素(CD62P)、sTLT-1、低密度脂蛋白(LDL)、Lp-a、PCSK9、肿瘤坏死因子-α(TNF-α)、γ-干扰素(IFN-γ)、IL-17A、白细胞分化抗原40(CD40L)、sICAM1的含量以及血小板表面EMMPRIN、GPVI的荧光强度均显著高于钙化斑块患者,血清中高密度脂蛋白(HDL)的含量低于钙化斑块患者,且软斑块患者血清中PAF、CD62P、sTLT-1、LDL、Lp-a、PCSK9、TNF-α、IFN-γ、IL-17A、CD40L、sICAM1的含量以及血小板表面EMMPRIN、GPVI的荧光强度均显著高于混合斑块患者,血清中HDL的含量低于混合斑块患者。差异均有统计学意义(P<0.05)。结论:冠心病患者C冠状动脉造影斑块性质的变化与血小板聚集、脂代谢紊乱及炎症反应激活密切相关。

Objective：To study the correlation of CT coronary angiography plaque properties with platelet function and serum biochemical indexes in patients with coronary heart disease.Methods：A total of 101 patients who received CT coronary angiography examination and were diagnosed with coronary heart disease in Tianmen first people＇s hospital between March 2015 and October 2017 were selected as the research subjects and divided into 3 groups：soft plaque group（n=28）,mixed plaque group（n=33）and calcified plaque group（n=40）,according to the CT results;the serum levels of platelet function indexes,lipid and inflammatory biochemical indexes were determined.Results：SerumPAF,CD62P,sTLT-1,LDL,Lp-a,PCSK9,TNF-α,IFN-γ,IL-17 A,CD40 Land sICAM1 levels as well as platelet surface EMMPRIN and GPVI fluorescence intensity of patients with soft plaque and mixed plaque were significantly higher than those of patients with calcified plaques whereas serum HDL level was lower than that of patients with calcified plaque,and serumPAF,CD62P,sTLT-1,LDL,Lp-a,PCSK9,TNF-α,IFN-γ,IL-17A,CD40 Land sICAM1 levels as well as platelet surface EMMPRIN and GPVI fluorescence intensity of patients with soft plaque were significantly higher than those of patients with mixed plaque whereas serum HDL level was lower than that of patients with mixed plaque（P〈0.05）.Conclusion：The changes of CT coronary angiography plaque properties in patients with coronary heart disease are closely related to platelet aggregation,lipid metabolism disorder and inflammatory response activation.