增龄性冠状动脉斑块钙化特征分析在男性冠心病防治中的应用价值

Practical value in the prevention of coronary heart disease by using intravascular ultrasound for age-related coronary artery plaque calcification

目的利用血管内超声(IUVS)评价增龄性冠状动脉钙化斑块的形态学特征并分析其在冠心病防治中的应用价值。方法选取行冠状动脉造影(CAG)及IVUS检查的青年组、中年组、老年组三组不同年龄段男性冠心病患者103例,在介入治疗前对钙化病变血管进行IVUS检查,获取血管外弹力膜面积、斑块狭窄面积、管腔钙化斑块狭窄率,测量病变钙化弧度、钙化长度比与钙化指数,并进行年龄因素相关分析。结果①随着年龄的增长,各组靶血管病变的血管外弹力膜面积和斑块面积均有逐步减少与升高的变化趋势,差异有统计学意义(P<0.05)。②钙化弧度、重度钙化率、钙化长度比随着年龄增长而呈现显著增加趋势,在老年组变化程度最明显(P<0.05)。③相关性分析发现钙化相关指标与增龄后的管腔斑块狭窄等指标有显著正相关(P<0.05)。结论随着年龄的增长,斑块钙化的程度逐渐加重,且呈现向心性演变趋势。在IVUS辅助下进行钙化特征相关指标的测定对指导男性冠心病患者复杂钙化病变的介入治疗有重要意义。

Objective To analyze the morphological characteristics of aging coronary artery calcified plaque by using intravascular ultrasound. Methods 103 cases with coronary heart disease from chest pain center underwent coronary angiography (CAG) and IVUS and were selected and divided into different age groups.IVUS was used to examine the vessel with calcified lesion and obtain target vascular stenosis lumen area,plaque area,luminal stenosis rate,calcified plaque,stenosis rate,calcified radian,calcified length ratio and calcification index.Correlation with age was analyzed. Results (1)As the growth of the age,each target vessel vascular pathological changes of external elastic membrane area and plaques area were reduced gradually and the change of the rising trend had significant statistical significance ( P <0.05).(2)Calcified radian,severe calcification,calcified length ratio increased with age,the changes in old groups were significant( P <0.05).(3)Correlation analysis found that related parameters of calcification were positively related with the narrow lumen plaques with age increasing ( P <0.05). Conclusions With the growth of the age,the degree of plaque calcification increases gradually,and presents the centrality of change.Combining calcified radian,calcified length ratio and determination of calcified index have important clinical significance for guiding the interventional treatment of complex calcified lesions.