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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2011年第6期

页码:

790-793

栏目:

临床研究

出版日期:

2011-12-25

文章信息/Info

Title:

Study on atherosclerotic plaque composition in patients with intermediate coronary stenosis by multidetector computed tomography angiography, serum matrix metalloproteinase 9 and soluble CD40 ligand

作者:

任 丽¹; 王 阶¹; 冯 玲¹; 赵 晶²; 康德强²; 刘贵建³; 冯 雪³

中国中医科学院广安门医院：1.心内科,3.检验科,北京 100053；2.北京中医药大学东方医院放射科，北京100078

Author(s):

REN Li¹;  WANG Jie¹;  FENG Ling¹;  ZHAO Jing²;  KANG De-qiang²;  LIU Gui-jian³;  FENG Xue³

1.Department of Cardiology, 3.Clinical Laboratory, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China; 2.Department of Radiology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China

关键词:

冠状动脉临界病变; 多层计算机体层摄影血管造影; 斑块特征; 基质金属蛋白酶-9; 可溶性CD40L

Keywords:

intermediate coronary stenosis;  multidetector computed tomography angiography;  plaque character;  serum matrix metalloproteinase 9;  soluble CD40 ligand

分类号:

R541.4

DOI:

-

文献标识码:

A

摘要:

目的:通过64层计算机体层摄影冠状动脉血管造影识别冠状动脉临界病变患者的冠脉斑块成分，并检测血清基质金属蛋白酶-9（MMP-9）、可溶性CD40配体（sCD40L）水平，探讨其斑块稳定性及临床意义。方法： 选择经64层计算机体层摄影冠状动脉血管造影证实至少有1支冠脉某一阶段狭窄30%～70%的患者65例，其中稳定型心绞痛36例，不稳定型心绞痛29例，通过斑块CT值及冠脉管腔碘造影剂CT值确定其斑块类型：非钙化斑块，钙化斑块和混合斑块；并用ELISA方法测定患者及37例无心血管疾病对照组血清MMP-9、sCD40L水平，比较其差异性并探讨其相互关系。结果： 冠脉临界病变患者混合斑块最多，其次为非钙化斑块，钙化斑块最少，“混合斑块+非钙化斑块”显著多于钙化斑块数目；患者血清MMP-9、sCD40L水平显著高于无心血管疾病对照组。结论： 冠心病冠脉临界病变斑块多为易损斑块。

Abstract:

AIM:To study the atherosclerotic plaque composition in patients with intermediate coronary stenosis using multidetector computed tomography angiography (MDCTA) and to explore the relationship between serum matrix metalloproteinase 9, soluble CD40 ligand level and plaque composition. METHODS: Enrolled in the study were 65 patients aged (62±8) years, including 36 patients aged (61±1) years with stable angina pectoris (SAP) and 29 patients age (64±8) years with unstable angina pectoris (UAP) with at least one segment of coronary diameter stenosis 30%-70% confirmed by contrast-enhanced 64-DCTA. Plaque composition in coronary arteries was determined by plaque CT value based on Hounsfield units (HU): noncalcified, calcified, or mixed, and serum MMP-9 and sCD40L expressions were measured in both patients and 37 volunteers age (46±15) years without coronary heart disease (CHD). RESULTS: Plaques found in patients with intermediate coronary stenosis were mixed (118, 46%), noncalcified (85, 33%) and calcified (54, 21%) and the number of mixed plus noncalcified was significantly higher than the number of calcified (P<0.05). The levels of serum MMP-9 and sCD40L were higher in patients and lower in volunteers without CHD (P<0.01, P<0.05). CONCLUSION: Patients with intermediate coronary stenosis have a higher burden of mixed and noncalcified plaques and higher activities of serum MMP-9 and sCD40L. Thus, it is important to stabilize the vulnerable plaques so as to prevent and reduce acute cardiovascular events.

参考文献/References

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备注/Memo

备注/Memo:

收稿日期：2011-05-15.基金项目：首都医学科技发展基金项目资助（SF-2009-Ⅱ-02）； 中国博士后科学基金项目资助 通讯作者：王阶，主任医师，主要从事心血管疾病的中西医结合基础及临床研究Email:wangjie0103@yahoo.com.cn 作者简介：任丽，主治医师，博士后Email:anda98@163.com

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更新日期/Last Update: 2011-12-27