ACS患者斑块特征与冠状动脉慢血流现象的相关性

Correlation between plaque characteristics and coronary slow flow phenomenon in patients with ACS

目的观察血管内超声(IVUS)识别下的冠状动脉斑块特征与冠状动脉造影术中发生冠状动脉慢血流现象(CSFP)的关系,探讨CSFP的可能机制。方法选择急性冠状动脉综合征(ACS)并行冠状动脉造影的患者,其中CSFP患者65例纳入CSFP组,冠状动脉血流速度正常患者70例纳入对照组。收集两组患者的临床资料、冠状动脉造影数据及IVUS相关数据,分析其与CSFP的相关性,计算ROC曲线下面积。结果CSFP组具有薄纤维帽粥样斑块(TCFA)者多于对照组(P<0.05)。CSFP组脂蛋白a水平明显高于对照组(P<0.05)。多因素Logistic回归分析显示脂蛋白a(OR=3.546,P<0.05)和TCFA(OR=3.827,P<0.05)是冠状动脉非罪犯血管发生CSFP的独立危险因素。ROC曲线下面积为0.809(95%CI 0.794~0.916)。结论ACS患者冠状动脉非罪犯血管的TCFA和脂蛋白a水平是CSFP的独立危险因素。

Aim To observe the relationship between the characteristics of coronary plaque identified by intravascular ultrasound(IVUS)and coronary slow flow phenomenon(CSFP)during coronary angiography,and to explore the possible mechanism of CSFP.Methods Sixty five patients with acute coronary syndrome(ACS)and coronary angiography were included in the CSFP group,and 70 patients with normal coronary flow velocity were included in the control group.The clinical data,coronary angiography data and IVUS related data of the two groups were collected,and the correlation with CSFP was analyzed.Calculate the area under the ROC curve.Results The number of patients with thin fibrous cap atherosclerotic plaque(TCFA)in CSFP group was more than that in control group(P<0.05).The level of lipoprotein a in CSFP group was significantly higher than that in control group(P<0.05).Multivariate Logistic regression showed that lipoprotein a(OR=3.546,P<0.05)and TCFA(OR=3.827,P<0.05)were independent risk factors for CSFP.The area under ROC curve was 0.809(95%CI 0.794-0.916).Conclusion TCFA and lipoprotein(a)are independent risk factors for CSFP in ACS patients.