冠状动脉粥样硬化斑块形态及介入治疗与MMP

冠状动脉粥样硬化斑块形态及介入治疗与的

关系

摘要】目的探讨急性冠脉综合征（ACS）及稳定型心绞痛（SA）患者外周血基质金属蛋白酶）、巨噬细胞集落刺激因子、反应蛋白（CRP)的水平与斑块形态特征的关系以及介入治疗后的变化。方法 62例

患者分为ACS组35例，SA组27例。分别采用速率散射光比浊法和酶联免疫吸

附法检测所有患者介入治疗前后外周血、、CRP的浓度。根据冠

脉造影斑块形态特征将冠脉斑块分为Ⅰ、Ⅱ、Ⅲ型。根据超声特点将颈动脉斑

块分为易损型和稳定型，比较ACS、SA患者斑块的型别及介入治疗前后MM、、CRP水平的变化。结果① 介入治疗前ACS组患者、、CRP水平高于SA组（P＜0.05)；②ACS和SA患者介入治疗前后、、CRP水平差异有统计学意义（P＜0.05)；③ACS组患者冠脉斑块主要为Ⅱ型，颈动脉斑块主要为易损斑块，SA患者则冠脉斑块主要为Ⅰ、Ⅲ型，颈动

脉斑块主要为稳定斑块；④不同斑块类型、、CRP浓度不同，冠

脉斑块Ⅱ型较Ⅰ、Ⅲ型显著升高（P＜0.05)，颈动脉斑块中易损斑块较稳定斑

块显著升高（P＜0.05)。第一论文范文网编辑。

结论外周血、、CRP的水平和斑块特征与斑块的稳定性有关，对于冠脉事件有一定的预示作用。

【关键词】基质金属蛋白酶血管成形术支架植入术动脉硬化 C反应蛋白

巨噬细胞集落刺激因子

and structural characteristics of plaques and percutaneous coronary intervention

WANG Ying1,

ZHANG Mei3, ZHANG Yun3,

(1. Department of Cardiovascular, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine，

Jinan 250001, China; 2. Department of Cardiovascular, Jinan

Third Hospital, Jinan 250101, China;

3. Department of Cardiovascular, Qilu Hospital of Shandong University, Jinan 250012, China)

To explore the plasm

patients with ACS and SA before and after percutaneous coronary intervention, so as to quantify the relation between structural

Methods 35 patients with acute coronary syndrome and 27 patients

and CRP levels were determined by the speed diffused light

turbidimetric method and by enzyme association immunity adsorption

law before and after percutaneous coronary intervention. Based on coronary angiography plaque morphology, the patch was typed as Ⅰ, Ⅱ and Ⅲ and based on ultrasound for the carotid artery, plaque was typed as stable and unstable plaques. Results ①

P levels were

significantly higher in the ACS group than those in the SA group（P＜

in the ACS and SA patients before and after intervention treatments

（P＜0.05). ③ The majority of the coronary plaque of the ACS group was type Ⅱ and of the carotid artery plaque was vulnerable, which were significantly different from those of the SA group（P＜0.05).

④ Conclusion

plaque structural characteristics and plaque stability.

Key words：

transluminal coronary angioplasty; Stent implantation;

factor

伴随继发血栓形成的斑块破裂被认为是急性冠脉综合征（acute coronary syndrome,ACS）的主要发病机制。第一论文范文网整理。

有多种因素参与了斑块的破裂，如炎症、血液流变学改变、血管壁的应力、血

管的收缩、斑块稳定性等。易损斑块形成、破裂的关键环节是单核／巨噬细胞

向斑块内浸润并释放基质金属蛋白酶(matrix metalloproteinases, MMPs）［1］。巨噬细胞集落刺激因子

、反应蛋白（，CRP) 等炎性因子也与斑块稳定性有关，参与了ACS的发病。冠心病的介入治疗可进一步使外周血、CRP等炎性因子水平增高［2］。本研究通过对ACS、稳定型心绞痛（stable angina pectoris, SA）患者冠状动脉斑块及颈动脉斑块的特征进行观察，并且检测冠心病介入治疗前后外周血、SCF、CRP的水平，初步探讨了斑

块特征与外周血、、CRP水平的关系和冠心病介入治疗对外周血、、CRP水平的影响。

1 资料与方法

1.1 临床资料将62名就诊于山东大学齐鲁医院的冠心病受试者（不

合并高血压、糖尿病、高血脂以外的病变）分为ACS组和SA组。ACS组：根据

美国心脏病学会/美国心脏协会(American College of Cardiology/American Heart Association,ACC/AHA)诊断标准［3］诊为ACS患者35例，其中男25例，女10例，41～86岁，平均（58.7±10.1）岁。其中急性心肌梗塞19例，41～

79岁，平均（54.4±11.3）岁，不稳定性心绞痛（unstable angina pectoris，