冠心病患者血清半乳糖凝集素3水平与冠状动脉斑块成分的相关性分析

The Correlation Analysis Between Serum Galectin-3 Level and Characteristics of Coronary Plaques in Patients with Coronary Heart Disease

目的通过血管内超声-虚拟组织学成像技术(VH-IVUS)分析冠心病患者的斑块成分,并研究斑块性质与血清半乳糖凝集素3(galectin-3)的相关性。方法冠心病患者257例,其中稳定型心绞痛(SA)85例,急性冠状动脉综合征(ACS)172例,对照组120例,均行冠状动脉造影检查,造影结果符合冠心病诊断标准的患者进一步行血管内超声检查,记录灰阶和VH-IVUS(VH-IVUS)相关数据,检测患者血清中半乳糖凝集素3、高敏C反应蛋白(hs-CRP)水平,分析其与斑块成分相关性。结果 3组患者的一般资料差异无显著性;ACS组血管重塑指数、坏死核心(NC)、斑块偏心指数均高于SA组,差异有统计学意义(P<0.05),斑块中纤维脂质(FF)与纤维组织(FT)比例均低于SA组,差异有统计学差异(P<0.05)。ACS组患者血清半乳糖凝集素。hs-CRP水平明显高于SA组及对照组,差异有统计学意义(P<0.05)。在ACS患者,血清半乳糖凝集素3水平与斑块中NC所占比例、斑块偏心指数、血管重塑指数呈正相关(r=0.632,P=0.017;r=0.640,P=0.020;r=0.615,P=0.021)。结论 ACS斑块多为偏心性斑块、斑块中坏死核心比例较大,SA斑块多由纤维组织或纤维脂肪组织构成;血清半乳糖凝集素3、hs-CRP水平与斑块中坏死核心所占比例、斑块偏心指数、血管重塑指数呈明显正相关。

Aim To analyze characteristics of the coronary atherosclerotic plaques in patients with acute coronary syndrome( ACS) and stable angina( SA) through the virtual histology-intravascular ultrasound,and study the correlation between the coronary atherosclerotic plaques and serum Galectin-3. Methods 257 patients with coronary heart disease( SA group( n = 85),ACS group( n = 172),the control group( n = 120) were examined and diagnosed as CHD by coronary angiography and patients with CHD will be examined by intravascular ultrasound further to record the gray-scale and virtual histology image data,test the serum Galectin-3 level and hypersensitive C-reactive protein level,analyze the correlation between these results and the coronary atherosclerotic plaques characteristics. Results There were no obvious diversity in general information among three groups. The results of VH-IVUS show: the vascular remodeling index,the proportion of necrotic core and plaque eccentricity index in ACS group were higher in the SA group. The diversity was statistically significant( P < 0. 05). Galectin-3 in ACS group is higher obviously than Galectin-3 in the SA group and control group,the diversity was statistically significant( P < 0. 05). There was a positive correlation between Galectin-3 and the proportion of necrotic core plaque remodeling index and plaque eccentricity index in ACS group( r = 0. 632,P = 0. 017; r = 0. 640,P = 0. 020; r = 0. 615,P = 0. 021). Conclusion( 1) Coronary atherosclerotic plaques in ACS are mostly made of necrotic core,partial plaques. Coronary atherosclerotic plaques in SA are mostly made of fibrous tissue or fibro-fatty tissue.( 2) There was a obviously positive correlation between Galectin-3 and the proportion of necrotic core,plaque remodeling index and plaque eccentricity index in ACS group.